Contact Info

Please fill out the following questionnaire in order to set up an exploratory conversation with an associate from the Heights Group. Part One - Contact Details First Name: Last Name: Telephone: Town/City: Zip/Postal: Country: Email address: Part Two - About You Are you over 18 years old? Yes  No Best day & time to reach you? Which of the following reflects your desire to start a business? (Check as many as you wish) I was just curious to find out more I was looking for something for my spouse I am interested in exploring my options I am interested in doing something soon Where do you have access to the Internet? (Check as many as you wish) Home Work Local Library Friend or Relative What is your job status now? (Check as many as you wish) Employed part-time Employed full-time Self-employed Unemployed Retired Student What level of income are you hoping to generate from your business? (Pick one) $100-$300 per week $300-$1,000 per week $1,000-$3,000 per week $5,000-$10,000 per week More than $10,000 per week How did you become aware of the Heights Group? Any additional comments?