PBDStartups

If you are seeking a new business venture please take a few minutes to participate in this Confidential Survey. Information provided is for Product & Business Development, Inc. purposes only and will not be shared or disclosed with any third parties. Please include your email address and information you deem necessary so we can evaluate your survey and reply via email at no charge.

(* required information)
* First Name
* Last Name
* Email
* Re-Type Email
Year of Birth
US Citizen	Yes No
Married	Yes No
Home Address

Home Phone	--
Cell Phone	--
Education
Other Special Training
Employment or Business Name
Employment or Business Address

Annual Income
Net Worth
* What is your budget for a business
* Do you have a Financial Partner	Yes No
* Are Your Seeking Funding	Yes No
* If so, what amount
* Are you seeking a working partner	Yes No
* Do you have an idea or invention	Yes No
* If so, is it a pending patent	Yes No
* If so, do you have the patent	Yes No
* Do you have a prototype	Yes No
* Do you have a business plan	Yes No
* Do you have a website	Yes No
* If so, what is the website address
* Are you seeking a home based business	Yes No
* Are you seeking to buy into a business	Yes No
* Are you seeking to buy a business	Yes No
* What type of business are you seeking
* What type of business have you looked over
* What were your likes and dislikes of what you looked over
* Would you be involved in the business	Yes No
* Based on your past business experience your strengths are:
* Based on your past business experience your weaknesses are:
Rate yourself on a scale of 1 to 5 (5 being the strongest) in the following personality characteristics
* Independent	1 2 3 4 5
* Motivated	1 2 3 4 5
* Management	1 2 3 3 5
* Technical	1 2 3 4 5
* Creative	1 2 3 4 5
* People-Oriented	1 2 3 4 5
* Communicator	1 2 3 4 5
* Determined	1 2 3 4 5
* Sales/Marketing	1 2 3 4 5
* Crisis Manager	1 2 3 4 5
Any additional information that would be helpful in evaluating this Confidential Survey

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