Promoting the success of entrepreneurial ventures, and the growth of entrepreneurship in central Virginia.

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3/18/10 11:30 AM - 1:30 PM

3/22/10 9:00 AM - 12:00 PM

4/15/10 5:30 PM - 7:30 PM

5/20/10 11:30 AM - 1:30 PM
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CEO Mentoring Network Application

Please fill out the following application for consideration in the Venture Forum's Mentoring Network.

Personal Info
Name*:
Age:
Highest level of education/degree attained:
What local business or professional assocaitions are you a member of:
Home Address:
Email*:
Phone - Office:
Phone - Cell:
Phone - Home:
Years in Richmond:
Business Info
Company Name*:
Your Position:
Business Address:
Date founded or incorporated:
Type of Tax Entity:
Number of Employees:
2009 Sales:
2008 Sales:
Company Website:
Is this your first entrepreneural venture:
If this is not your first, how many businesses have you started/owned:
Do you have a written business plan:
Do you have a written budget for 2010:
Do you have a board of directors:
Do you have an accountant:
Is the company profitable:
If not profitable, does the business have a positive EBITDA:
Does the company have positive net worth:
Briefly describe the business you are in:
What are your 2-3 main business concerns that you would like advice in dealing with?:
Are you willing to provide 2 hours as a mentor to another CEO:
Please provide the name(s) and contact info for any other CEOs who might be interested in the Mentor Network:

Personal Info