“Turnaround Engagement” Research Project Application “Turnaround Engagement” Research Project Application Important Information:The information you provide here and at any point in the future will be kept strictly confidentially within our research team. That said, we understand the sensitivity of disclosing certain information. If an NDA is needed to answer any of the following questions, please ONLY provide information that does not require such an NDA. If we decide to engage your company in the program, we will address an NDA at that point. We are accepting application until April 30th. After reviewing the submitted applications, we will identify those that we feel could be a good fit and conduct a initial interview with the contact person given. From these interview we will narrow the candidate companies down to three or less with who to engage in Phase One as described in the proposal materials. Our target company profile is: An under-performing, early-stage Angel or VC Portfolio Company 6-15 team members A strong need, desire, and commitment to becoming a more effective and successful team A leader who is committed to “doing the work” of becoming a better thinker-leader We will be delivering $25K - $50K worth of world-class services PRO BONO* to the selected company(s) and its team. If your company is selected, all team-members will be expected to fully and earnestly participate in the program (and it's in the interested of your company's success that they do so). * Most of the services, other than the workshops, will be conducted via telephone and videoconference. Depending on the client company's location, we may need to request travel expense reimbursement . Primary Name Contact Name (Owner / CEO)* First Last Company Name*Location* City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State Best Phone Number*Email Address*You will NOT be placed on any mailing or marketing list outside this project. Enter Email Confirm Email If applicable, who referred you to this opportunity (name)?Without violating any NDA-worthy information, briefly describe the nature of the company's product(s) or service(s).Including yourself, how many full-time or otherwise key people are on the team (even if not on a payroll)*Company HistoryHow would you describe your most pressing "people problems" (including your own "issues") that you feel are undermining or limiting your company's success?*Which of the follow best describes where you are?*How critical and urgent is it that you get these "people problems" solved?Yesterday! - Seriously, it's critical.We're nearly at the end of our rope.It's a big issue, but we're not on the verge of failure.We heading in the right direction, but need help.It would just be nice. Other Comments or QuestionsTerms of Application*I understand that the information provided in this "Application" will, as a matter of practice, be kept private and shared only with members of the Research Team. However, I also affirm that no information provided in this "Application" exposes any "trade secrets" or other confidential information that would otherwise be covered under a Non-Disclosure Agreement (NDA) and that this "Application" does not serve as an NDA nor obligate either or any party, in any way, to any future engagement, services, participation, or other relationship. I Understand and Agree to the above Terms of Application. NameThis field is for validation purposes and should be left unchanged.