Name
E-mail address
Telephone number
Address line 1
Address line 2
City, State, ZIP

1. My main reason for wanting to own my own business is:

Earn more money
Prestige
Freedom to set my own schedule
Job enjoyment

2. In my own business, I expect to work:

6 hours per day
8 hours per day
10 hours per day
12 hours per day

3. I will work weekends in my own business:

When I have to
When I need to
No problem; I expect to work weekends
I don't want to work weekends at all

4. I think my management skills are:

Excellent
Superior
Average
Below Average

5. Compared to others I have worked with:

I work harder than nearly everyone
I work as hard as others
I probably don't work as hard as the average worker

6. I will work harder in my own business than I would as an employee for someone else:

Agree
Disagree

7. Which of the following best describes me:

I like a job with the same routine each day
I prefer every day to be different

8. I want to know today what tomorrow's tasks will be:

Agree
Disagree

9. It bothers me when someone changes my schedule:

Agree
Disagree

10. I enjoy working with my hands:

Very much
Somewhat
Neutral
Not at all

11. I need for others to tell me I am doing a good job:

Very much
Appreciate, but not necessary
Not at all

12. I come from a background where my parents (guardians) owned their own business:

Yes
No

13.Age at which I had my first part-time job:

What kind of job was it?

14. I like a job where I can measure my daily performance:

Very much
Not necessary
Do not enjoy measuring performance or being measured

15. It is important to me to be liked:

Yes, very much
No, not important

16. I like to discuss important financial matters with others prior to making a decision:

Yes, it is important
Sometimes
No, I usually decide alone

17. I would guess there are new car dealers within 30 minutes' drive of where I live.

18. I would guess there are used car dealers (do not count used car departments of new car dealers) within 30 minutes' drive of where I live.

19. What is the most important thing you can offer most customers?

Best price
Quickest service
Highest quality
Name recognition

20. Heavy advertising can overcome inconsistent quality:

Agree
Disagree

21. I would expect my new business to be profitable:

Immediately
Within 3 months
Within 6 months
Within 1 year

22. When things go wrong in my job, usually:

I find that someone else is responsible
I could have done something about it

23. I would expect to own my new business for:

2-3 years
4-5 years
6-10 years
11+ years

24. I prefer:

To start the workday early and finish relatively early
To start the workday later but am willing to work later

25. I feel the strongest positive characteristic I would add to a business is:

26. My greatest weakness in a business might be:

27. The one person (not a name, just a title or relationship) whose opinion I would most value in deciding on a certain business would be:

28. How important is it that I immediately earn the same income in my new business that I earn in my current position?

Extremely important
Somewhat important
Not crucial
I expect to earn less for awhile

29. It is important that I find the right business:

Within 30 days
Within 60 days
Within 90 days
Within 180+ days
No timetable

30. Utilizing a total score of 100%, I will base my decision to buy a certain business on (insert percentages in the boxes below; numbers should add up to 100):

Feedback from others in the business
Perception of how much I think the business is "right" for me
Earnings potential
Feelings of other family members
Other (please specify):

31. I would strictly follow a weekly marketing plan in my new business:

Agree
It depends on time required
I would reply on my previous experience

32. I think it is important to "shop" for insurance at every anniversary date:

Agree
Disagree

33. I find that service providers work harder at earning your business than keeping your business:

Agree
Disagree

34. I meet people easily:

Strongly agree
Somewhat agree
Neither agree nor disagree
Strongly disagree

35. On a scale of 1 to 10 (10 being the highest), answer each of the following:

I have sales ability Please Choose an Option 1 2 3 4 5 6 7 8 9 10
I am a people person Please Choose an Option 1 2 3 4 5 6 7 8 9 10
I have common sense Please Choose an Option 1 2 3 4 5 6 7 8 9 10
I have good color perception Please Choose an Option 1 2 3 4 5 6 7 8 9 10
I enjoy intricate work Please Choose an Option 1 2 3 4 5 6 7 8 9 10
I work quickly Please Choose an Option 1 2 3 4 5 6 7 8 9 10
I want to do things exactly right Please Choose an Option 1 2 3 4 5 6 7 8 9 10
I will put my work up against anybody's Please Choose an Option 1 2 3 4 5 6 7 8 9 10
I enjoy taking an occasional afternoon off Please Choose an Option 1 2 3 4 5 6 7 8 9 10
I follow directions well Please Choose an Option 1 2 3 4 5 6 7 8 9 10
I like to discover a better way Please Choose an Option 1 2 3 4 5 6 7 8 9 10
I enjoy working on cars Please Choose an Option 1 2 3 4 5 6 7 8 9 10

36. Which describes me best?  I would rather:

watch television OR work in the garden
read a book OR assemble something
hire it done OR do it myself
supervise OR do it myself
teach someone else OR do it myself
write a report OR visit a new customer
work inside OR work outside

37. In evaluating a business opportunity, how important is each of the following (rank each on a scale of 1-10, with 10 being the highest):

Easy to learn Please Choose an Option 1 2 3 4 5 6 7 8 9 10
Easy to teach others Please Choose an Option 1 2 3 4 5 6 7 8 9 10
Ability to grow Please Choose an Option 1 2 3 4 5 6 7 8 9 10
Environmentally friendly Please Choose an Option 1 2 3 4 5 6 7 8 9 10
Freedom of schedule Please Choose an Option 1 2 3 4 5 6 7 8 9 10
Low overhead Please Choose an Option 1 2 3 4 5 6 7 8 9 10
Broad product/service mix Please Choose an Option 1 2 3 4 5 6 7 8 9 10
Predictable earnings Please Choose an Option 1 2 3 4 5 6 7 8 9 10
Home-based Please Choose an Option 1 2 3 4 5 6 7 8 9 10
Low product cost Please Choose an Option 1 2 3 4 5 6 7 8 9 10

38. The best age to start your own business would be (disregard your present age):

25-30 years old
30-35 years old
35-40 years old
40-45 years old
45-50 years old
50-55 years old
55+ years old
Why do you feel that way?

39. I feel there are quite a few businesses that I could enjoy:

Agree
Disagree

40. I am willing to travel to another city to be trained in my new business:

I expect to
I will if necessary
Somewhat reluctant
This would be a problem
Absolutely not

This completes the questionnaire.  Click "submit information" below to send the form; we'll forward our complete brochure and video to you, along with instructions for further investigations.  Best wishes in your search for the business that offers you most everything you are looking for!  It is definitely out there for the finding if you are willing to take the time to look.