W1SD0M

The w1sd0m surveys and polls are designed to continuously improve our understanding of each other and the industries and individuals involved in global change. As you contribute you will have access to aggregate data, and you will begin to find new connections. All in all, this is an exchange.

This Survey is Private

Basic Information

Personal

Salutation: *

First Name: *

Last Name: *

Suffix:

Email: *

Impact

I am primarily a(n): *

Secondary activity (if applicable):

What is your work primarily concerned with?: *

Where does your work have impact?: *

Where do you live?

Country: *

Postal Code: *

Media

What social media do you use?: *

If other, please list:

In the following four capital categories, please tell us what you are seeking.

Social (what connections would help your progress the most?): *

Human (what key team members are you looking to add in next three months?): *

Intellectual (what key information or know-how do you need to resolve a challenge?): *

Financial (if raising within next six months, if longer, enter zero): *

In the following three categories, what do you have to offer?

Social (describe the nature of the connections you can make): *

Human (describe the job you would like to have at a venture, or the professional services you provide (ie: legal, financial, etc.): *

Intellectual (what areas of expertise can you share?): *

In which stage of development is your organization?: *

Concept

Pre-revenue

Revenue, but not yet cash flow positive

Cash flow positive

Profitable and expanding

What do you believe w1sd0m can do for you?: *