Your name:

E-mail address:

Address (optional):

City:

State: Zip:

Phone (include area code):

Please fill out this brief survey to help us better understand you and your company. (optional)

Do you currently own or run a business?
Yes No

If so, what type of business are you in?

service / retail
agriculture
manufacturing
transportation
 other

What Iowa county are you located in?

Which of these topics are you most interested in learning about?
(check all that apply)

business planning
human resource management
financing your venture
bookkeeping / accounting
marketing
insurance / legal
taxes
understanding your credit
computer software / technology
 other

Would you like to see classes offered in these topics?
Yes No

Which of the following times would you most likely attend a workshop or seminar?

other, please specify

What type of Internet connection do you have?

less than 56K dial-up modem
56K modem
high speed connection

Do you have some immediate needs we can help with? (If yes, please specify in the comment box below)
Yes No

Questions/Comments: