Name
Street Address
Address (cont.)
City
State/Province
Zip Code
Country
Work Phone
Home Phone
FAX
E-mail

Type of business are you looking for? Please be as specific as possible.

How much income do you need a business opportunity to provide?

Target investment level?

Please choose $20,000 to $30,000 $30,000 to $40,000 $40,000 to $50,000 $50,000 to $60,000 $60,000 to $70,000 $70,000 to $80,000 $80,000 to $100,000 $100,000 to $125,000 $125,000 to $150,000 $150,000 to $175,000 $175,000 to $200,000 $200,000 to $250,000 $250,000 to $300,000 $300,000 to $350,000 $350,000 to $400.000 $400,000 to $500,000 $500,000 to $750,000 $750,000 to $1,000,000 $1,000,000+

Business location? Please be as specific as possible.

Are you interested in commercial or investment property in Arizona?

Please choose Yes Maybe No

Are you planning on relocating to Arizona? If yes, when?

How soon would you like to be in business?

Please choose Now Next 3 months 3 to 6 months Over 6 months

Comments or questions?