Your Name*

Email address*

Business Name and location?*

How many years have you been in business?*

Is your business virtual or brick and mortar?*

Business Website*

What type of business are you running? (Give us a brief description)*

How big is your team?*

What is your average annual gross revenue? Are you profitable?*

In a quick sentence or two, tell us what piqued your interest about the Profectus Team?*

Are you interested in releasing a little bit of equity to bring our team on board and help you grow or are you looking for a full exit?*

What are the Top 3 Challenges in your business you are facing right now?*

How much money do you need in your opinion? What would the money be used for?*