Small Business Plan and Proposal for Assistance
Name:	Phone Number:
Cell Phone:	Date:	
Address:

	City	State and Zip Code	
Section A. General
1.	What is the name of your business:
	
2.	Which form of business are you proposing?
Sole Proprietorship                                ________ Partnership                                             ________
Limited Liability Company (LLC)    ________	Other type of Corporation                    _________
Franchise                                              _________
If existing business, be prepared to show state registration and proof of business organization	
3.	Describe your business. What products or services do you intend to offer? Emphasize any unique appeal of your products or services.

	
4.	Do you have or do you plan to have any employees or contractors working for you? If so, how many and briefly describe their job functions.

	
5.	Why do you want to be self-employed?

	
6.	List your monthly sources and amounts of income. 

7.	What is your monthly income goal after expenses for your business?

8.	What are your monthly personal expenses?	
Rent/Mortgage	$	Out of pocket medical 	$	
Utilities (Gas and Electric)	$	Clothing	$	
Water/Trash	$	Auto – gas	$	
Food	$	Auto – insurance	$	
Telephone	$	Auto – maintenance	$	
Cell phone	$	Personal items	$	
Internet	$	Entertainment	$	
Cable/Satellite TV	$	Other (pets, hobbies)	$	
Medical Insurance	$	Credit Cards	$	
Life Insurance	$	Loans	$	
Other	$	Other	$	
Total this column	$	Total this column	$	

TOTAL personal expenses (both columns): $__________________________

Section B. Education and Training
1. What education or training have you had?  

High School      
Completed       Yes   No	School or college name	Course or program	Dates attended	Completed	
				Yes   No	
				Yes   No	
				Yes   No	
				Yes   No	
2. List your work experiences – Employers	From	To	Job title or responsibilities	

				

				

				
3. Briefly describe experience or training you have in:
	
Business administration

	Personnel Administration	
Sales and marketing

	Office Management	
Accounting or Bookkeeping

	Other business skill	

Section C. Customers and Marketing
1.	List three to five past, current, or potential customers who have expressed an interest or intent to use your product or services.

	
2.	List three additional potential customers who you would like to contact but have not to this point.

	
3.	To what segment of the population is your small business targeted? Who will most likely be your primary customer?	
Men or women?	Where do they live?
	What need will your product or service fill?

	
What ages? 
	Where do they purchase?
	When do they need your product or service?

	
Income level?
	Other characteristics?
	How much do they usually spend for your kind of product or service?

	
What are your customers looking for?
	Other

	Other

4.	How do you know your product or service will be needed or desired? What have you done to find out the answer to this question?

	
5.	How will you promote your business? How will potential customers learn about your product or service?	
Networking – How?

	Flyers/Brochures – How will you distribute them?

	
Print Advertising – Which publication and why that one?

	Business cards – How will you use them?

	
Yellow pages

	Internet Advertising – How?

	
Radio/TV Advertising – Where and why?

	Other?

6.	List the names and locations of three of your competitors. List one strength and one weakness for each. Use the reverse of this sheet if needed.
	
Competitor 1. Name

	Competitor 2. Name
	Competitor 3. Name
	
Location

	Location	Location	
One Strength

	One Strength	One Strength	
One Weakness

	One Weakness	One Weakness	
7.	How do you compare with your competition? What will your strengths be? Explain	
Price

	Quality	
Service (Responsiveness, flexibility, customer relations, follow-up)

	Volume

	Other

8.	Compared to your competition, what would your weaknesses be?	
Price

	Quality	
Service (Responsiveness, flexibility, customer relations, follow-up)

	Volume

	Other

9.	What actual and potential risks will you have in starting your business and how will you deal with them?	
Effects of competition	Personal experience

	
Funding

	Ability 	
Health

	Other	
10.	List prices for your products or services.

  	
11.	List typical prices from your competitors for similar products or services.

	
12.	What is the address where you will conduct your business?

	
13.	Where will you sell or deliver your products or services? 

	

Section D 
Start-Up Costs Business Assets 

Start-up Costs
Below is a list of start-up costs that may apply to your business. Use this list as a guide to create your own list of start-up costs. Be sure to enter the cost under the column that shows DVR assistance is not requested or DVR assistance is requested.  Use additional sheets as needed	
City or County Business Registration
Occupational License
Anticipated legal fees 
Marketing – Advertising in print publications 
Marketing – Yellow pages
Marketing – Business Cards
Marketing – Flyers or brochures
Marketing – Other
Liability insurance or Bonding
Rent or lease
Bookkeeping Services	Professional/Trade Association Membership
Insurance or Bonding
Tools 
Equipment Initial Stock 
Supplies 
Training 
Work site modifications 
Special Assistive Devices
Other	

Start-up Costs for My Business
Item	Vendor Name	Cost (DVR assistance not requested)	Cost (DVR assistance is requested)	

				

				

				

				

				

				

				

				

				

				

Total				

Business Assets You are Contributing
Item	Estimated Fair Market Value	

		

		

		

Total		

Section E. Income and Expense Projections.
Discuss your income and expense projections to include:	
1.	What would be a realistic income projection or goal for your first month in business (that is, the first month after you receive DVR assistance and you are able to generate income from your business)?

2.	How many hours of service do you have to provide or how many of your products do you have to sell to meet your first month’s income projection?

3.	How many hours of service do you have to provide or how many of your products do you have to sell to  meet business and personal expenses after DVR assistance ends?

4.	How will you be able to increase your number of customers in order to increase your monthly business income? 

	

Section F. Conclusions.
Briefly discuss the factors that you believe will make your business successful.

	

Attach any letters of intent or agreements from customers or potential customers to use your services or to 
purchase your products.