| Print form using the
browser print function under file, print preview and print |
SERVICE CORPS OF RETIRED EXECUTIVES
ASSOCIATION
CLIENT SELF-ASSESSMENT WORKSHEET
CASE NUMBER______ |
The most important thing for you to determine for either
your existing business or a new start-up is: What is required for the
business to succeed? For SCORE counseling to be helpful in determining
this, it is important that certain basic information be provided. We
request that, if possible, before your first counseling session you take
the time to fill out this worksheet. If there are questions that you do
not understand just leave them blank and the counselor will help you.
Remember, SCORE counselors are bound by a code of ethics to treat all
information in strict confidence.
DESCRIPTION OF THE BUSINESS OR IDEA:
THE FIRST QUESTION TO EVALUATE IS: DOES THE BUSINESS OR
IDEA FOR A PRODUCT OR SERVICE, HAVE SUFFICIENT UNIQUENESS TO BE
COMPETITIVE IN THE MARKET PLACE?
IS IT NOW OFFERED BY ANYONE
ELSE?__________________________________________
DOES IT SATISFY AN UNFILLED
NEED?___________________________________________
DOES IT OFFER A CONVENIENCE NOT NOW AVAILABLE?___________________________
DOES IT CREATE A
TREND?_____________________________________________________
IS IT ENVIRONMENTALLY
SENSITIVE?_____________________________________________
DOES IT PLAY TO THE CUSTOMERS SENSE OF VALUE?____________________________
DOES IT OCCUPY A SPECIAL
NICHE?_____________________________________________
CAN IT BE
PATENTED?_________________________________________________________
IS THE MARKETING STRATEGY DIFFERENT?______________________________________
IS THE CUSTOMER SERVICE DIFFERENT?________________________________________
DOES IT UTILIZE SPECIAL TALENTS OF THE
CLIENT?_______________________________
OTHER COMMENTS?___________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
THE SECOND QUESTION IS: DO YOU POSSESS THE CHARACTERISTICS OF AN
ENTREPRENEUR TO MAKE THE BUSINESS SUCCEED?
DO YOU HAVE DRIVE, ENERGY AND TOTAL COMMITMENT? _______________
ARE YOU: SELF-CONFIDENT?__________________________________________
A REASONABLE RISK TAKER?_________________________________________
INNOVATIVE?________________________________________________________
COMPETITIVE?_______________________________________________________
DO YOU: SET HIGH STANDARDS TO MEET?______________________________
WANT TO CONTINUALLY IMPROVE YOUR INCOME?_______________________
CONSIDER DOLLARS AS A MEASURE OF SUCCESS?_____________________
DO YOU HAVE THE JOB SKILLS FOR YOU BUSINESS?____________________
ARE YOU WILLING TO LEARN SOMETHING NEW?________________________
CAN YOU MANAGE: PEOPLE?_________________________________________
CAN YOU MANAGE: MONEY?__________________________________________
SERVICE CORPS OF RETIRED EXECUTIVES
ASSOCIATION
CLIENT SELF-ASSESSMENT WORKSHEET
Page 2
THE THIRD QUESTION IS: WHAT IS YOUR PERSONAL SITUATION AS IT RELATES TO
THE VENTURE?
DO YOU CURRENTLY HAVE JOB SECURITY?_____________________________
WHERE DO YOU CURRENTLY WORK?__________________________________
WHAT IS YOUR OCCUPATION?_________________________________________
DO YOU HAVE OTHER SOURCES OF INCOME?__________________________
ARE THEIR POTENTIAL SOURCES OF INCOME - CAN SPOUSE WORK?______
WHAT ARE YOUR FUTURE JOB PROSPECTS VS GOING INTO BUSINESS____
IS THE VENTURE SUPPORTED BY THE FAMILY?_________________________
WHAT IS THE CONDITION OF YOUR HEALTH?____________________________
CAN YOU AFFORD TO BE SICK?_______________________________________
DO YOU HAVE MEDICAL INSURANCE?_________________________________
THE FOURTH QUESTION IS: WHAT IS YOUR FINANCIAL SITUATION AS IT RELATES
TO THE VENTURE?
SOME CLIENTS ARE RELUCTANT TO PROVIDE THIS INFORMATION BUT BE ASSURED
THAT IT WILL ALL COME OUT IF YOU PLAN TO OBTAIN FINANCING. THE INFORMATION
IS VITAL FOR THE SCORE COUNSELOR TO HELP YOU PUT TOGETHER A FINANCIAL
PACKAGE THAT WILL MEET YOUR NEEDS.
IT IS ALL CONFIDENTIAL.
WHAT IS THE VALUE OF YOUR CURRENT ASSETS?______________________
WHAT IS THE VALUE OF YOUR CURRENT PERSONAL DEBT?______________
HOW MUCH DOES THIS COST YOU PER MONTH?________________________
WHAT IS THE OUTSTANDING DEBT OF YOUR BUSINESS?_________________
HOW MUCH ARE THE MONTHLY PAYMENTS FOR THE BUSINESS DEBT?_____________
ARE YOU BEHIND IN PAYMENTS FOR YOUR PERSONAL DEBT, IF SO, HOW MUCH?_______
ARE YOU BEHIND IN PAYMENTS FOR YOUR BUSINESS DEBT, IF SO, HOW
MUCH?________
HAVE YOU EVER BEEN IN PERSONAL OR BUSINESS BANKRUPTCY?________________
HOW MUCH PERSONAL INCOME DO YOU
NEED?_______________________________________
OTHER COMMENTS:
________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
|