FREE BUSINESS NEEDS ANALYSIS
AND APPLICATION
All of the information in this Business Needs Analysis
will be held in strictest confidence.
You may complete as much of the form as you wish; however,
the more information we have
about your business, the better we can help you.
Please mail this form to:
CPI Business Development Corp.
PO Box 6350
Portland, Oregon 97228-6350
Or send it by fax or e-mail:
Print this form and fax it to: 1-(503) 289-0055
Or copy and paste this form and e-mail it to:
needs-analysis@cpibusiness.com
Name of Your Business:
Street Address:
City, State, Zip:
Mailing Address, if different:
Phone:
Fax:
E-mail:
No. of Owners:
Owner name 1:
Owner name 2:
Owner name 3:
1. Why or how did you start this business?
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
2. How many employees do you have?
[ ]
None [ ] 1 - 10 [ ]11 -
25 [ ] 26 - 50 [ ] 51 -100
[ ] 101 - 200
[ ]
Over 200 [ ] Other
_______________________________________________
3. How many managers do you have?
[ ]
1 – 5 [ ] 6 -10
[ ] More than 10
[ ]
Other ______________________________________________________________
4. Are you getting the results you want from your
people?
[ ]
Yes [ ] No
[ ] Some
[ ]
Other ______________________________________________________________
5. Do you have quality standards for your people?
[ ] Yes [
] No
[ ]
Other ______________________________________________________________
Are your standards documented
and published? [ ] Yes
[ ] No
[ ]
Other ______________________________________________________________
6. Have you created clear accountabilities for your
people? [ ] Yes
[ ] No
[ ]
Other ______________________________________________________________
Do you have personal performance
contracts with your people? [ ] Yes
[ ] No
[ ]
Other ______________________________________________________________
7. Do you have a recruiting and hiring system?
[ ] Yes [
] No
Other __________________________________________________________________
8. Have you created an organizational chart defining
the functions of your business?
[ ] Yes
[ ] No
[ ] Other
______________________________________________________________
9. Why is now the time to take a look at your
business?
[ ]
I work too many hours [ ] Health [
] Family [ ] Stress [ ]
Compensation
[ ]
Other ______________________________________________________________
10. What has been your experience as a business
owner?
[
] Very satisfying [ ] Somewhat satisfying
[ ] Frustrating [ ] A nightmare
[
] Other _____________________________________________________________
11. How close have you come to reaching the vision
or goals you had for this business?
[
] Have reached it [ ] Have come close
[ ] Have not reached it
[
] Have given up on reaching it
[
] Other _____________________________________________________________
12. What type of business do you own?
[
] Service [ ] Manufacturing
[ ] Professional [
] Retail
[
] Wholesale [ ] Other ______________________________________________
13. Where are your customers/clients located?
[
] Local [ ] Statewide
[ ] Regional [
] National [ ] International
[
] Other _____________________________________________________________
14. How do you obtain most of your clients?
[
] Referral [ ] Reputation
[ ] Telemarketing [
] Direct Mail
[
] Media Advertising [ ]Yellow
pages [ ] Direct Sales
[
] Other _____________________________________________________________
15. What marketing methods have you tried?
[
] Telemarketing [ ] Direct Mail
[ ] Media Advertising [
] Yellow Pages
[
] Direct Sales [ ] Internet
[
] Other _____________________________________________________________
16. What results have you had with your marketing
efforts?
[
] Excellent [ ] Good
[ ] Fair [
] Poor
[
] Other _____________________________________________________________
17. Do you have a marketing strategy in place for
future growth? [ ] Yes
[ ] No
[
] Other _____________________________________________________________
18. Do you have a marketing budget?
[ ] Yes [ ]
No
[
] Other _____________________________________________________________
19. Type of business: [
] Sole proprietor [ ] Corporation
[ ] Partnership
[
] Other _____________________________________________________________
20. How profitable is your business?
Annual Gross Revenue:
Net Profit:
[ ]
Don’t Know
21. Describe your cash flow: [
] Excellent [ ] Good [
] Fair [ ] Poor
[
] Inconsistent [ ] Other ____________________________________________
22. Are you paying your bills on time? [
] Yes [ ] Most of the time [
] Sometimes
[
] No [ ] Other ____________________________________________________
23. Do you have any long-term debt?
[
] Yes [ ] No
[
] Other _____________________________________________________________
24. If you answered Yes in question 23, are you
on a scheduled payback structure?
[
] Yes [ ] No
[
] Other _____________________________________________________________
25. What are the terms of payment for your clients/customers?
[
] 10 Days [ ] 15 Days
[ ] 30 Days [ ] 45
Days [ ] 60 Days
[
] Other _____________________________________________________________
26. How are your receivables/collections?
[
] Excellent [
] Good [ ]
Fair [ ] Poor
[
] Other _____________________________________________________________
27. What type of financial reports do you generate?
[
] P & L [ ] Balance Sheet
[ ] Projections [
] Budget [ ] None
[
] Other _____________________________________________________________
28. How often do you generate these reports?
[
] Weekly [
] Monthly [
] Quarterly [
] Annually
[
] Other_____________________________________________________________
29. List the 3 most important issues or challenges
facing your business:
1. ____________________________________________________________________
2. ____________________________________________________________________
3. ____________________________________________________________________
30. What is the purpose of your business?
[
] To eventually sell it [ ] Franchise
it [ ] Use it as an income source
[
] Stay involved doing the strategic work
[ ] Leave it as a legacy
[
] Other ____________________________________________________________
31. Do you have a mission statement for your business?
[ ] Yes [ ] No
[
] Other ____________________________________________________________
32. Do you have a vision statement for your business?
[ ] Yes [ ] No
[
] Other ____________________________________________________________
For what period of
time? [ ] One year
[ ] Three years [
] Five years
[
] Other ____________________________________________________________
33. Please include anything about your business
that will help us to recommend a course of action.
34. I prefer to communicate with CPI Business Development
Corp. by:
[
] Telephone [ ] Fax
[ ] E-mail [ ] Mail
(check
all that apply)
The best time to
reach me by telephone for free consultation is:
[
] Mornings at _____________ a.m. (in my time zone)
[
] Afternoons at _____________ p.m. (in my time zone)
[
] Anytime
___________________________________________________
Print Name of Principal Owner
___________________________________________________
Signature of Owner
________________________________
Date
Thank you for your interest in our business development
program.
copyright 2000 CPI Business Development Corp.
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