* First Name * Last Name *City * State/Province * Country * Email Address * Confirm Email Telephone * Highest Level of Education Completed Elementary School High School Technical School 2 years of College 4 years of College Post Graduate Degree * Are you currently Working       Yes    No Occupation Full-Time   Part-Time   Your Work Hours * If you choose to use our Consulting Service What hours of what days are you available? * Do you have a computer?    Yes        No   Dial-Up    Broadband * On a scale from 1 to 5, How Computer savvy are you? (1 being the least savvy) One Two Three Four Five * On a scale from 1-5, How savvy are you at  searching the Internet? (1 being the least savvy) One Two Three Four Five * Have you ever attempted to start an Internet Business before?  If so, please describe in some detail the kind of business.  Yes     No Please describe the Business in some detail. * How many telephone lines do you have in your home? Zero One Two Three Four Five More than Five * Do you have any hobbies that you are passionate about?  Please list them all. Yes       No Please list all your hobbies * Would you consider yourself very knowledgeable about a particular subject?  This could be hobby related, work related or in general. Yes     No Please list the areas of your extensive knowledge *How much time per week right now are you willing to dedicate to your business? 1 to 5 hours 5 to 10 hours 10 to 15 hours 15 to 20 hours 20 to 25 hours 25 to 30 hours 35 to 40 hours As long as it takes * Should you succeed with your business, How much time are you willing to spend per week to grow your business? 1 to 5 hours 5 to 10 hours 10 to 15 hours 15 to 20 hours 20 to 25 hours 25 to 30 hours 30-35 hours 35 to 40 hours As long as it takes * Do you have any kind of budget put aside to pursue an Internet Business?  Just give me some idea of what you can or can't afford in order to make this happen. This may sound like a personal question but it's essential in determining which path to take. * Please briefly describe your reasons for wanting to own and operate your own Home Internet Business. Do you have any additional comments you'd like to make? *   By checking this box you warrant that you are over 18 years of age. *   Check here to confirm that you have read and agree to our Terms of Service should you decide to use our services or purchase products via our web site. Thanks for taking the time to fill out this form.  Please push the submit button below and I'll get back to you shortly.