Checking Vital Signs


See below and send enough information to get us interested and we will get back to you within 48 hours.

Note: You can remain anonymous at this point, only giving the information marked* - if you prefer

Your Email Address:
(Important you type it here - or we will not have it)


Your Full Name:

Company Name:

Company Address

Your Telephone Numbers
(including national & local dialing codes):

*What is the company's primary business
(example: Manufacturing - Electronics - Communications)
if more than one, please list:

*Annual sales (gross revnue) for 2007, 8, 9:

*EBITDA for 2007, 8, 9
(Earnings before interest, taxes, depreciation and amortization):

*List your company's 5 largest costs, in order of size:
(eg: raw materials, payroll, subcontracting, utilities, services)

The greatest challenges you see facing your business/company/industry:

*Can your principals be avaivalable to speak with our principals
by telephone on short notice?
If not please suggest alternative.

By submitting this form you are not suggesting that your company needs the sort of
assistance we have outlined here, nor do we assume so. We will hold all information given
here, and all future information you may make available to us in strictest confidence,
divulging it to no one beyond our immediate principals, partners and executives.