Pilot Survey 1

Basic Information

Personal

Salutation: *

First Name: *

Last Name: *

Suffix:

Email: *

Where do you live?

Country: *

Postal Code: *

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

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?

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?: *

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