This Form Is For Small Business Owners Interested In Participating In The Great American Small Business Challenge

This Form Is For Small Business Owners Interested In Participating In The Great American Small Business Challenge

What is the name of your Company? *
Which business entity best describes your company; Sole Proprietor, S-Corp, C-Corp, LLC, Other? *
What is your Job Title or Position? *
What is your First and Last name? *
What is your Area Code and Telephone number, please include both Office and Cell? *
What is your Email address? *
What is your Company's web site URL? *
What is your Company's Street address, please include City, State and Zipcode? *
Please describe the products and/or services that you provide? *
Do you have the authority to make or influence decisons? *	Yes No
What is your annual operating budget? *
How many full-time employees do you have? *
How many part-time employees do you have? *
Do you utilize independant contractors? *	Yes No
Do you have more than one business location? *	Yes No
Do you have any operations oversees? *	Yes No
Do you have any remote or off-site workers? *	Yes No
Describe your level of skill and experience using various computer and/or office programs? *
Describe your level of skill and experience using the internet? *
Describe your level of skill and experience in sales and networking? *
What type of organizational infrustructure do you have in place that supports your strategic objectives and organizational mission? *
What type of organizational, project or performance management software are you currently using? *
What type of quality management of continuous quality improvement program do you have in place? *
Describe the type of help or training you would like for your Board? *
Describe the type of help or training you would like for yourself and/or your Executive Team? *
Describe the type of help or training you would like for your Employees? *
Are you familiar with the resources and services that your local Small Business Development Centers (SBDC) offers? *	Yes No
Are you familiar with the resources and services that the Small Business Administration (SBA) offers? *	Yes No
Are you familiar with the resources and services that SCORE offers? *	Yes No
Are you currently utilizing the resources and services of your local Small Business Development Center (SBDC)? *	Yes No
Have you ever utilized the resources or services of the Small Business Administration (SBA), SCORE and/or your local Small Business Development Center (SBDC)? *	Yes No
If you have previously utilized or are currently utilizing the resources and/or services of the SBA, SCORE or your local SBDC, please name the agency, the type of services provided and tell us about your experience?
Are you familiar with the American Society for Qualitiy's Small Business Network (ASQ SBN) and the resources and services ASQ offers to its members? *	Yes No
Are you a currently a member of the American Society for Quality (ASQ)? *	Yes No
Would you be interested in joining ASQ's Small Business Network? *	Yes No
Are you familiar with the criteria for the Malcolm Baldrige National Quality Award? *	Yes No
Have you ever utilized or are you currently utilizing the services of a business coach or managment consultant? *	Yes No
If you have utilized or are currently utilizing the services of a management consultant or business coach, please tell us about your experience?
Where did you hear about the GASBC? *
What is the primary motivation for becoming a GASBC participant? *
Are you interested in joining our Online Community? If yes, please sign-up at www.greatamericansmallbusinesschallenge.com. *	Yes No
Have you told your friends, colleagues and fellow business owners about the GASBC? (If no, please help spread the word!) *	Yes No