| General
Information About Your Business |
| Legal Name/
Entity* |
The legally registered name of your
company |
| Business Name/ Operating As* |
The name your company is know by, or uses to
conduct business e.g. ACME Consulting |
| Parent Company |
If your company is owned by another entity, the
name of the entity e.g. Acme Global Industries |
| Address Line #1* |
The street address of your company. This is the
main office address where all official correspondence is to be
sent (Not a remittance or other operational address) (e.g.: Head
Office) |
| Address Line #2 |
The suite, unit or rural route number/ name |
| Address Line #3 |
|
| City Town* |
The name of city or town |
| Province/ State* |
The name of the Province or State (2 letter abbr.)
Or name of region for outside Canada & US |
| Country* |
Select either Canada, or US. If Other, or enter
name of the country |
| Postal/Zip code |
A valid postal or ZIP code used in your address |
| Main Telephone Number |
The general telephone number for your company
(pre-formatted) |
| Toll free telephone number |
The general toll free telephone number of your
company (pre-formatted for 10 digit number) |
| Business
Detail |
| Year Business started |
The date your company started (Month/Year) |
| Number of employees |
The total number of employees in your company at
the time of completing this form |
Annual revenue
(3 years average) |
The total (Gross) annual income of your company |
| URL/ web site address |
The web site (internet) address of your company |
| Corporate status |
Provide the legal status of your company (sole
proprietorship, partnership, private corporation, public
corporation, joint venture, franchise, non profit) |
| Province/ State of Incorporation |
If incorporated, enter the province or state (enter
the Region beside Other if International |
| Country of Incorporation |
If incorporated, enter the country (enter the
Country beside Other if International) |
| Geographic
Location Services (check all that apply) |
| Locations |
Check all location codes that your company
currently services. If your company services other global
locations, please specify in the General Description area below |
| Business
Sector (check all that apply) |
| Sectors |
Check all sectors that apply to your company |
| Business
Services/ Offerings (check all that apply) |
| Services/ Offerings |
Check all services/offerings that your company
provides. Definition examples for each are shown in the status bar
(below left of screen) or shown using F1 key. Multiple options may
apply to your company. If the services/offerings are not listed,
select Other and provide comments in the text box or in the
General Description area below |
| General Description: A brief description of the
services or offerings provided by your company (Maximum 255
characters) |
| Company
Contact Information (check all that apply) |
| Prefix |
Select prefix for the company contact from the menu list |
| First Name |
The first name of the company contact |
| Last Name |
The last name of the company contact |
| Title |
The title of the contact person named above |
| Telephone Number |
The telephone number, including area code, of the contact named
above (pre-formatted). If outside Canada or US, enter the complete
telephone number beside Other |
| Extension |
The telephone extension for the contact person listed above |
| Fax number |
The fax number for the contact person listed above If outside
Canada or US, enter the complete fax number beside Other |
| E-mail Address |
The complete email address for the contact person listed above |
| Preferred contact method |
Select the method to contact the above person (if further
contact is required) |
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