Salmon Arm Business Development Program

Please complete this form. It will be submitted to our business coach who in turn will contact you for an appointment.

STEP ONE: Contact Information
Personal Information	Business Information
* = required field
Personal First Name: *	Business Name: *
Personal Last Name: *		If no business name yet exists, please enter your full name here.
Personal Address:	Business Address: *
Personal City:	Business City: *
Personal Province:	Business Province:
Personal Postal Code:	Business Postal Code: *
Personal Telephone:	Business Telephone: *
Personal Fax:	Business Fax:
Personal Cell:	Business Cell:
Personal E-mail:	Business E-mail:

STEP TWO: Business Information
Primary Business Industry:	Secondary Business Industry:	Business Type:	Business Ownership:
		Business Type:
Existing Sales: Yes No	Annual Sales:	F/T Employees:	New Employees:
Projected Sales: Yes No	Annual Sales:	P/T Employees:	Volunteers:

Please self-assess your business skills in the following areas. (1 being low, 10 being high).
Management:	Product/Service:	Marketing:	Financial:

STEP THREE: Business Stage Information
Business Stage Start Up Early Mid Late	Funds Required? Yes No
	If yes, how much?

STEP FOUR: Professional Services
Do you currently have any of the following professional services? Check all that apply.
Legal	Accounting	Other

STEP FIVE: Demographics
Gender: Male Female	Does your business belong to any of the following associations?: Chamber of Commerce Shuswap Construction Industry Professionals Women In Business Downtown Improvement Association
Age Range: For statistical purposes only, we request that you indicated your age bracket; however, you are not required to provide this data.
If you are entitled to any special grants or financial assistance (i.e. First Nations Funding, Disability Grants), please specify here.)	Referred By: Details:

STEP SIX: Interview

1. Tell me a little about yourself and your background.

2. Could you share with me some of your thoughts around the business idea and or why the business has been successful to date?

3. What do you believe are going to be your three challenges/issues in starting/developing/expanding the business?

4. If there was a couple of things that you absolutely did not want to change about the existing business, what would they be and why?

5. Where do you believe your business growth/expansion will come from over the next couple of years?

Salmon Arm Economic Development
Business Development Program

PO Box 130
Salmon Arm, BC V1E 4N2
Phone(250) 833-0688
Fax (250) 833-0609

Geri Byrne
Business Coach
Email

Lana Fitt
Economic Development Manager
Email

Administration
Email