USA LEADERSHIP CORPS
SMALL BUSINESS PARTNER APPLICATION

Please complete the below fields in order to create a report 
that will help us assess your overall business needs and strategy.

Please email your completed form to info[@]usaLeadershipCorps[.]org

Personal Information
First Name:     
Last Name:   

Company Information
Company Name:         
Website (required):  
First year of revenue generation (must equal 1 year or older):     

Number of staff that are compensated, including yourself (must equal 1 or more):
Postal Zip Code:    

Service/Product Offered (example - educational services):
Target Customer Demographic (example - children between the ages of 10 and 12):     

Are you a primary 'decision-maker' within your company?   Yes     No  
If not, please provide...
--> primary decision-maker's name:  
--> primary decision-maker's email:  

Financial Goals
What is your current annual level of financial success? Must be greater than $0:  

What is your desired annual level of financial success? Must be greater than $0:  

Plans and Initiatives
Describe the activities that you plan to implement in order to achieve the stated financial goal.
1.  
2.  
3.  

Professional Needs
What type of marketing, financial, or business strategy planning assistance can USALC provide that 
can help you achieve the above stated goal?
    
USALC incurs significant marketing, training, and other administrative costs to facilitate high-quality 50-hour, 
3-month consulting experiences for our members. Our consultants subsidize 80% of these costs. Is the 
professional need you described above worth our consultants' considerable time and financial support?   Yes     No  

Additional Insight, Questions, or Feedback for USALC?
 


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Please email your completed form to info[@]usaLeadershipCorps[.]org