Business Name * When would you prefer consulting services? * Fall 2018 Spring 2019 Summer 2019 Please provide a brief description of your business or startup. * Business Website Business Social Media Accounts (please provide) How many years has the company been in operation? * How many people does your company employ? * Select which revenue description best fits your business. * - Select -Pre Revenue/StartupEarly Stage with Initial SalesEstablished Business or Organization What do you believe are the three most important challenges facing your company? What are the 2-3 objectives that the consulting team can help you accomplish to assist you with the challenges you listed above? * Please consider that these projects should be able to be completed within the allotted time of the class. Identify a business project that can be completed during the course. Sample projects have included: competitive analysis customer discovery or business model canvas product development research product market fit research value proposition research revenue stream analysis international expansions social media strategy partial marketing plan strategic business planning market research and analysis [Optional] Please upload any relevant documents that will help the consulting team understand the scope of the desired project and your current business standing. (i.e. competitive table, business model canvas, marketing plan, executive summaries, brochures, etc.)Files must be less than 2 MB.Allowed file types: gif jpg jpeg png txt rtf html pdf doc docx odt ppt pptx odp xls xlsx ods xml. How did you hear about this program? * Has your business participated in the Iowa JPEC Venture School program? Yes No Has your business previously received business consulting services from Iowa JPEC students? Yes No Is your business affiliated with the University of Iowa? Yes No RELEASE AND INDEMNIFICATION AGREEMENT In consideration for your participation in the University of Iowa’s John Pappajohn Entrepreneurial Center’s Entrepreneurial Business Consulting class (Class), you agree to release, waive, and forever discharge: the University of Iowa; the Board of Regents, State of Iowa; and the State of Iowa and their students, employees, agents and representatives (Releasees) from any and all liability of any and every nature whatsoever that you may have, for any and all personal injury, including death, and for loss of or damage to property, caused by your participation in the Class, except to the extent such liability is caused by the negligence or wrongdoing of any of the Releasees. You further agree to defend, indemnify and hold harmless the Releases from and against all liability, loss, damage, cause of action, cost and expense, including reasonable attorneys’ fees, caused by your negligence or wrongdoing, or the negligence or wrongdoing of any of your employees or agents in the course of your participation in the Class. The undersigned agrees that s/he has read the foregoing, understands its terms and voluntarily signs it with full authority to do so. Name of Contact Person Completing Application * First and last name Contact's Title * Contact's Phone * Contact's Email * Company Address * Iowa County * Signature * Date (mm/dd/yyyy) * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year20162017201820192020 2+2