Half Century Win Business Assessment

A multi-step assessment form for established business owners applying for a paid business strategy engagement.

First Name

Last Name

Email *

Phone *

Company name

Country *

State / Region

Business Web Site *

1. What industry or sector does your business operate in?

2. How many years has the business been trading? *

Less than 1 year.
1 - 2 Years.
3 - 5 Years.
6 - 10 Years.
More than 10 Years.

3. What is the approximate annual turnover of the business? *

Under A$250,000
A$250,000-A$500,000
A$500,000-A$1,000,000
A$1 million–A$2.5 million
A$2.5 million–A$5 million
A$5 million–A$10 million
More than A$10 million

4. Approximately how many people work in the business, including owners? *

1
2-5
6-10
11-20
21-50
More Than 50

5. Briefly describe what your business does and how it generates revenue.

6. Was the business profitable during the most recent financial year? *

Yes
No
Approx Break-Even
Not Sure

7. Compared with two years ago, is profitability: *

Improving Significantly.
Improving Slightly.
About the Same.
Declining Slightly.
Declining Significantly.

8. How would you describe your current cash-flow position? *

Very Strong.
Comfortable.
Tight At Times.
Frequently Difficult.
Critical.

9. Do overdue debtors materially affect your cash flow? *

Yes
No
Unsure

If 'Yes' - Briefly Explain.

10. Are creditors, taxation liabilities, loans or other financial commitments currently placing pressure on the business? *

If 'Yes' - please briefly explain.

What are the three biggest challenges facing your business today? *

What concerns you most personally as the business owner? *

13. What do you believe is currently holding the business back? *

14. Which areas would you most like assistance with? *

Sales
Business Development
Marketing
Profit Margins
Pricing
Cash Flow
Debtors
Creditors
Staffing
Management
Systems and Processes
Productivity
Growth
Cost Control
Customer Concentration
Strategic Direction
Succession
Exit Planning
Owner Workload
Other

15. Is there a significant business decision you are currently considering? *

If yes, please briefly describe it.

16. Where would you like the business to be 12 months from now? *

17. Where would you ideally like the business to be three years from now? *

18. Which of the following best describes your immediate objective? *

Grow the Business.
Improve Profitability.
Improve Cashflow.
Reduce my Workload.
Stabilise the Business.
Prepare the Business for Sale.
Prepare for Succession.
Turn Around a Struggling Business.
Decide Whether to Continue Operating.
Other.

If we could improve one aspect of the business, what would make the greatest difference? *

What result would make the A$999.95 engagement worthwhile for you? *

21. How open are you to having your existing business practices challenged? *

Very Open.
Open.
Somewhat Open.
Not Particularly Open.

22. If I believe something you are currently doing is hurting the business, are you comfortable with me saying so directly? *

Yes.
Probably.
Unsure.
No.

23. Are you prepared to make changes that may initially be uncomfortable if there is a strong commercial reason for doing so? *

Yes.
Possibly.
No.

24. Are you willing to provide the financial information requested as part of this assessment? *

Yes.
No.
Some Documents May not be Available.

Why are you seeking outside business advice at this time? *

Please provide the following documents where available and applicable to your business. The information supplied will be used only for the purpose of reviewing your application and, if you proceed, preparing for your Business Strategy Engagement.Paragraph

Profit & Loss Statement — Most Recent Financial Year

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