Form

Business Consulting

business consulting form

Business Name

Point of Contact (person filling out the form)

Please enter your phone number (cell phone preferred)

Please enter your email address.

Please enter your physical address (Address, City, State, Zip Code)

Company FEIN

Type of Business

Date Business Started

For your most recent year, what was your gross revenue/sales?

For your most recent year, what were your profits/losses?

Describe specific assistance requested in the space provided

Business Ownership: What percentage of your business is male or female owned?

Business Ownership Race/ Ethnicity: What race/ethnicity is the primary owner (more than 50%)

Veteran Status

Total Number of Employees: (Full & Part‐time)

REQUEST FOR CONSULTATION

Agreement:
I request business consultation service from Transform U. I understand that any information disclosed will be
held in strict confidence. Transform U will not provide your personal information to commercial entities. I
waive all claims against Transform U personnel, and that of its Resource Partners and host organizations,
arising from this assistance.

Your Signature

Select a date

Thanks for submitting!

As a new client of Transform U, we'd like to advise you of certain rights and responsibilities you have as one of
our clients:

You have a right to expect:

Prompt, courteous, and professional services and to be advised if Transform U is unable to provide service within the time frame required.
All information shared with Transform U and any of its resources will be held in strictest confidence. No information provided by you will be used to the commercial advantage of any employee at Transform U or to the benefit of any third party.
That your client status with Transform U will remain confidential. No public use of your name, address, or business identity will be made without your prior approval.

Our role is to assist business owners and those planning to go into business. We will not make business decisions or judgments for you, though we will make recommendations and suggestions as appropriate. These will be based upon our best efforts to apply the experience and resources available to us to assist you in making your own business decisions.

In consideration of Transform U furnishing you with management and technical assistance, you agree to waive all claims against Transform U and its constituent institutions, its staff, or any other resources employed by or used in connection with these services.