Contact Questions

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Now that you know something about United Marketing Solutions, this questionnaire will tell us a little about you. The information you provide is confidential and will not be shared with anyone else outside of United Marketing Solutions. It will allow us to send you more detailed information and samples of our products.

Notice: Sections in BOLD must be completed.

Your Name
Address
City
State
Zip
HomePhone
WorkPhone
E-mail	Don't put anything in the following field:
What do you do now?

Best Time to Call

Morning Afternoon Early Evening (6 - 8 PM) Evening (8 - 10 PM)

Where would you like to develop a business?

City/Metropolitan Area State

How long have you been looking?

Weeks 3 - 6 Months 6 - 12 Months Over 12 Months

When would you like to be operational?

Weeks 3 - 6 Months 6 - 12 Months Over 12 Months

Will anyone else be involved? If yes, who?

Self Spouse Family Member Partner

How much time will you devote to the business per week?

<10 10 - 20 20 - 30 30 - 40 >40 hours

What are your annual income goals?
First Year < 25 k 25 - 50 k 50 - 75 k 75 - 100 k > 100 k	Second Year < 25 k 25 - 50 k 50 - 75 k 75 - 100 k > 100 k	Third Year < 25 k 25 - 50 k 50 - 75 k 75 - 100 k > 100 k

What amount are you planning to invest in a business?

< 25 k 25 - 50 k 50 - 75 k 75 - 100 k > 100 k

What is your net worth?

<50 k 50 -100 k 100 - 250 k 250 - 500 k >500 k