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MEMBER'S QUESTIONNAIRE

To:        Prospective Member

From:   Cicardi Bruce & Rich Pisani

Subj:     AMG Members Questionnaire

Date:     May 13, 2014

Dear Prospective Member,

Thank you for reviewing our website to gain interest in potentially being invited to join our AMG 'Business Advisory Board' program as a new Member of either our business owner group or upper level management team. Below is a detailed AMG Members Questionnaire with questions that needs to be answered openly and honestly by you regarding your company. This is our research instrument consisting of one hundred and twelve questions and other prompts for the purpose of gathering information from you about your company. Once you have been approved as a new Member and have decided to join a peer group advisory board you will need to complete this survey with help from your AMG Group Facilitator in your monthly private coaching sessions. It gives both you and AMG a chance to look at the 'big picture', colors and brush strokes that your company has created since its launch. This is a very rigorous assignment, but will by an eye-opener for you when you have completed this survey. This process will also help you build a bond of trust and confidence with your Facilitator, as well as help you in your business planning process.

Once you agree to join our program, but before you attend your very first team meeting, your AMG Group Facilitator will ask that you review all the questions first from top to bottom before actually answering the questions. Then, when you meet with your Facilitator for your monthly private coaching sessions they will cover your answers with you, plus discuss other issues you may want to cover. As a coach, your Facilitator will first question your answers, as well as answer your questions. Also, this survey will help both AMG and the new Member enhance a two-way business conversation and gather information that gives your Facilitator needed insight into you as an individual and your company. Plus, it helps you and your business coach set the stage for preparing your own AMG '90 Day Action Plan' and '5 Year Business Plan', which is a requirement for each Member during their first year on a team.

Please feel free to review these questions prior to applying for Membership and joining a team. It may help you clarify some of your own thoughts, ideas and suggestions on how you can improve your own skills as a leader, manager and problem solver. It can also help qualify your own interest in finding out more about our peers-helping-peers business support program.

We at AMG have designed our 'Business Advisory Board' program for business owners and upper level managers of small and medium size businesses who want and need to confidentially share their issues, concerns and problems with an experienced and trained AMG Group Facilitator and a peer group advisory board to solicit suggestions, ideas and advice from their leader and teammates. Once this process takes hold, entrepreneurs and top-tier personnel will become better leaders, managers and problem solvers, which will help improve the overall health and financial stability of their company. Thank you for your time and consideration in this matter. Please feel free to contact us if you have any questions so we can assist you by answering any questions you may have.

Cicardi A. Bruce

Chairman

314-941-0779 (c)

Richard T. Pisani

President

314-952-2640 (c)

400 Chesterfield Center - Suite 400

Chesterfield MO 63017

636-537-7720 (w) or 636-519-7222 (f)

www.amginc.biz

Member Questionnaire

General business questions:

(Please print clearly and comment to clarify)

 

1) What is your name and title with your company?

       Name: ________________________________________ Title: _________________

 

2) Can you describe your job description?

_______________________________________________________________________

_______________________________________________________________________

 

3) What is your area of authority and responsibility?

_______________________________________________________________________

_______________________________________________________________________

 

4) What is the legal name and d/b/a of your company?

______________________________________________________________

_______________________________________________________________________

 

5) What address at your company should we use for snail-mail?

_______________________________________________________________________

___________________________________________________________ Zip: _______     

 

6) What is the prime email address that you can be contacted at?

_______________________________________________________________________

_______________________________________________________________________

 

7) What is your personal contact information?

Cell: ____________________________ Work: _______________________________

Alt: ____________________________ Fax: _________________________________

 

8) What is your company's website address?

_______________________________________________________________________

 

9) How many square feet does your company work out of (leased or purchased)?

_______________________________________________________________________

_______________________________________________________________________​

 

10)Are you a regular C-Corporation, Sub-S Corporation, LLC, partnership or proprietorship?

_______________________________________________________________________

_______________________________________________________________________

 

11) What are your company owners names and percentage of ownership?

Name: _____________________________________________ % ________________

Name: _____________________________________________ % ________________

Name: _____________________________________________ % ________________

Name: _____________________________________________ % ________________

Name: _____________________________________________ % ________________

 

12) Are you an independent business or franchise and (if a franchise) under what name?

_______________________________________________________________________

_______________________________________________________________________

 

13) What are the hours of operation for company?

_______________________________________________________________________

_______________________________________________________________________

 

14) Have you considered going to a four-day work week (explain)?

_______________________________________________________________________

_______________________________________________________________________

 

15) Have you considered adding another shift to keep up with business (explain)?

_______________________________________________________________________

_______________________________________________________________________

 

16) How has your company done in these current economic times ($, # of employees, etc.)?​

_______________________________________________________________________

_______________________________________________________________________

 

17) Is your company name and logo protected by a trademark/service mark (yes or no)?

Name: _____________________________ Logo: ______________________________

 

18) Does your firm have a tag-line and if so what is it?

_______________________________________________________________________

_______________________________________________________________________

 

19) Does your firm have a jingle and if so what is it?

_______________________________________________________________________

_______________________________________________________________________

 

20) How many employees does your company currently have on the payroll (full-time vs part-time)?

_______________________________________________________________________

_______________________________________________________________________

 

21) How many of these employees report directly to you?

_______________________________________________________________________

_______________________________________________________________________

 

22) Who do you report to directly?

_______________________________________________________________________

_______________________________________________________________________

 

23) What promotions have you had in the past three years (describe)?

_______________________________________________________________________

_______________________________________________________________________

 

24) What was your personal annual income and benefit package worth for the past three years?

_______________________________________________________________________

_______________________________________________________________________

 

25) When do you plan on retiring or leaving your company and why?

_______________________________________________________________________

_______________________________________________________________________

 

26) How would your company do without you (explain)?

_______________________________________________________________________

_______________________________________________________________________

 

Questions about your business philosophy: (Please print clearly and comment to clarify)

1) Have you ever personally used a business consultant, coach or mentor?

_______________________________________________________________________

_______________________________________________________________________

 

2) Who at your company have ever used a business consultant, coach or mentor?

_______________________________________________________________________

_______________________________________________________________________

 

3) Have you ever been a member of a peer group advisory board or business support group?

______________________________________________________________

______________________________________________________________

 

4) Do you personally work with a business consultant?

______________________________________________________________

_______________________________________________________________________

 

5) Do you personally work with a business coach?

_______________________________________________________________________

_______________________________________________________________________

 

6) Do you personally work with a business mentor?

_______________________________________________________________________

_______________________________________________________________________

 

7) Do you have a current appraisal on your company and what is it value (in what year)?

_______________________________________________________________________

_______________________________________________________________________

8) What is the current fiscal years net worth on the balance sheet of your company?

_______________________________________________________________________

_______________________________________________________________________

9) Has your firm ever considered buying other businesses or competitors?

_______________________________________________________________________

_______________________________________________________________________

10) Has your firm ever considered expanding by franchising your business model?

_______________________________________________________________________

_______________________________________________________________________

11) What business networking groups do you belong to (explain)?

_______________________________________________________________________

_______________________________________________________________________

12) Do you feel you are fairly held accountable for your job description by your supervisor?

_______________________________________________________________________

_______________________________________________________________________

 

13) Do you use outsource or subcontract for certain projects (explain)?

_______________________________________________________________________

_______________________________________________________________________

 

14) How often do you hold productive meetings in your area of responsibility?

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

 

15) How often does your company hold an 'all employee only' meeting?

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

 

16) How often does your firm host a gathering of all employees and their families?

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

 

17) What type of recognition events does your company host and for what reason?

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

 

18) How often does your company officially recognize employees that excel (what areas)?

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

 

19) How often does your firm conduct an employee attitude survey?

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

 

20) How often does your firm conduct a customer opinion survey?

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

 

21) How many patents does your company hold (explain)?

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

 

22) What is your annual advertising budget?

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

 

22) What is your annual advertising budget?

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

 

23) What is your annual public relations budget?

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

 

24) What forms of advertising and public relations do you currently use?

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

 

25) Does your firm use advertising specialties with prospective clients and existing customers?

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

26) What can you do to improve your advertising and PR plan to make it work better?

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

27) Are you currently adding, staying the same-size or down-sizing your company personnel?

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

28) What is the current size of your firm? (sales; profit/loss; # of employees; # of clients, etc.)

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

29) Is your company up-to-date with its facility, vehicles, equipment and current technology?

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

 

30) What is your past three year fiscal track record? (gross sales; profit/loss; net worth)

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

 

31) What is your current fiscal year forecast (gross sales; profit/loss; net worth)?

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

 

32) What is your next five year forecast (gross sales; profits/loss; net worth)?

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

 

33) What is the total current amount of money you owe on your Account Payable?

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

 

34) What is the total current amount of money you have due on your Account Receivable?

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

 

35) What short term (under 12 months long) loans and leases do you have?

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

 

36) What long term (over 12 months long) loans and leases do you have?

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

 

37) What industry and kind of business is your company in?

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

 

38) What local, regional or national industry associations does your company belong to?

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

 

39) Who is your typical client (add detail and demographics)?

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

40) What is the $ amount of your lowest, average and highest billing customer in the last year?

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

42) What are your clients biggest problems and how does your company solve them?

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

43) Why would a prospective client cancel your competitor and start doing business with you?

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

44) Why would a prospective client cancel you and start doing business with your competitor?

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

45) Can you name the 5 biggest benefits your current clients receive from your product/service?

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

46) What specific areas of your company need a major improvement?

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

47) How many clients stop doing business with you on an annual basis and why?

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

48) Can you name your largest clients and what % of your gross revenue comes from them?

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

49) Who are your direct competitors in you market area (rank first to last place)?

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

50) Who is the biggest direct competitor in your market area and what is their % of the market?

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

51) Where does your company rank amongst competitors and what is your % market share?

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

52) What are some current major problems that you have to solve in the next 90 days?

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

53) What are some long-term major problems that you have to solve in the next 12 months?

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

54) What are your major foreseeable problems in the future you want to start working on soon?

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

55) What lawsuits is your firm currently involved in and why (plaintiff or defendant)?

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

56) What is your greatest fear or problem regarding your industry?

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

57) What is your greatest fear or problem regarding your direct competitors?

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

 

58) What is your greatest fear or problem regarding your own company?

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

 

59) What do you expect out of your AMG 'Business Advisory Board' teammates?

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

 

60) What do you expect out of your 'Private Coaching Sessions' with your AMG Facilitator?

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

 

61) What type of guest speakers/topics do you expect in our Business Advisory Board meetings?

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

 

62) What is the greatest asset you believe you bring to our Business Advisory Board meetings?

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

63) What is your greatest concern about attending our Business Advisory Board meetings?

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

64) What is your greatest concern about attending our Private Coaching Sessions?

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

65) What other questions do you want to answer?

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

 

Questions about your company's reputation:

(1). How would your current customers rate your company’s reputation?

Excellent: _____ Above Average: _____ Average: _____ Below Average: _____ Poor: _____

 

(2). How would your previous customers rate your company's reputation?

Excellent: _____ Above Average: _____ Average: _____ Below Average: _____ Poor: _____​

 

(3). How would your current vendors rate your company’s reputation?

Excellent: _____ Above Average: _____ Average: _____ Below Average: _____ Poor: _____

(4). How would your current employees rate your company’s reputation? 

Excellent: _____ Above Average: _____ Average: _____ Below Average: _____ Poor: _____

(5). How would your current management team rate your company’s reputation?

Excellent: _____ Above Average: _____ Average: _____ Below Average: _____ Poor: _____

(6). How would the local Better Business Bureau rate your reputation?

Excellent: _____ Above Average: _____ Average: _____ Below Average: _____ Poor: _____

(7). How would you rate you company’s reputation?

Excellent: _____ Above Average: _____ Average: _____ Below Average: _____ Poor: _____

(8). How would you rate your direct supervisors reputation at the company?

Excellent: _____ Above Average: _____ Average: _____ Below Average: _____ Poor: _____

(9). How would you rate your own reputation at the company?

Excellent: _____ Above Average: _____ Average: _____ Below Average: _____ Poor: _____

 

(10). How would your employees rate your management team reputation?

Excellent: _____ Above Average: _____ Average: _____ Below Average: _____ Poor: _____

 

(11). How would your employees rate your company owners reputation?

Excellent: _____ Above Average: _____ Average: _____ Below Average: _____ Poor: _____

 

(12). How would you rate your direct competitors reputation?

Excellent: _____ Above Average: _____ Average: _____ Below Average: _____ Poor: _____

 

(13). How would you rate your products reputation?

Excellent: _____ Above Average: _____ Average: _____ Below Average: _____ Poor: _____

 

(14). How would you rate your services reputation?

Excellent: _____ Above Average: _____ Average: _____ Below Average: _____ Poor: _____

 

(15). How would you rate your direct competitors reputation?

Excellent: _____ Above Average: _____ Average: _____ Below Average: _____ Poor: _____

(16). How would you rate your __________________________reputation?

Excellent: _____ Above Average: _____ Average: _____ Below Average: _____ Poor: _____

 

(17). How would you rate ______________________________ reputation?

Excellent: _____ Above Average: _____ Average: _____ Below Average: _____ Poor: _____

(18). How would you rate your ___________________________reputation?

Excellent: _____ Above Average: _____ Average: _____ Below Average: _____ Poor: _____

 

What is the current 'vision statement' for your company?

(Please print clearly and comment to clarify)

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

 

What is your personal 'vision statement' for yourself?

(Please print clearly and comment to clarify)

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

 

What is the current 'mission statement' for your company?

(Please print clearly and comment to clarify)

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

 

Comments/Questions/Suggestions/Ideas:

(Please print clearly and comment to clarify)

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

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