Developing Business Alliances (DBA) - Registration

Please complete the following questionaire. This information will not be used for any other purpose but to refer customers to you and create partnerships to enhance your business. You will be contacted if a potential match for your submission is found. FOR A LIMITED TIME JOINING IS FREE. But, please make a donation after you submit this registration. Your donation covers your basic business benefits until December 31, 2012 and supports DBA operations. Joint Cities is a 501(c) (3) non-profit. All donations are fully tax-deductible as per US law. Thank you for your time and consideration.

Contact Information

Name:
Company:
Title:
Email:
Cell phone:
Address:
web-site/URL
Office phone:

Do you have a "satisfaction guaranteed" policy?

How long have you been in business?

1-3 years
3-6 years
6+ years
Start-up

What is your industry? North American Industry Classification System (NAICS) Codes. Enter at least 1 code: *

(NAICS 2012 structure/classification) www.census.gov/epcd/www/naics.html

Tell us something about your business. (Maximum 200 characters)

Number of employees

Does your business have at least one social network profile?

What is your greatest challenge in your business?

What type of partnership do you imagine will best immediately benefit your business?

What type of partnership do you imagine will best benefit your business over the long term?

What is your most important question you'd ask of, or before choosing, a potential collaborative business or partnering entity?

What contractual opportunities do you seek? (Describe your "dream" contracts.)

Would you consider buying an existing business or franchise?

Yes
No
Maybe

Types of goods/services sold

Types of goods/services purchased

Outcomes: Have you attended DBA or partner events or followed up on referrals?

State outcomes and your comments.

(For example, number of contacts made, revenue generated, expectations or testimonials)

Will you compete in the elevator speech contest at "Think and Stay In The Black" finance and networking event?

Please affirm the following: You give Joint Cities Development, DBA Initiative, permission to use your quote.

Name and Title:
Company:
Email:
Web site:
Phone: