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*Date: D Y
*First and Last Name:
*Name of Company
*Your Title :
*Address:
*City:
*State:
*Zip (no dashes):
*Telephone (no dashes)
Fax
*Email
URL
Inquiry
Suspect
Prospect
Project
Imminent
Business Description
Project
Description
Of A Regional Nature?
Key Decision Factors
No. of Employees
Existing Skills
yes
no
Future Skills
yes
no
Training Requirements
yes
no
Start up Date
Decision Date
New Employment
Bldgs & Improvements $
Mfg. Machinery & Eqpt. $
Other $
Pollution Control Eqpt. $
Total Capital Investment $
Incentives - Federal, State and Local
Size
Rail Required
Rail Preferred
Rail Not Needed
Park
Independent
Either
Office
Manufacturer
Flex
Retail
 
Freestanding
Multi-tenant
Either
 
Existing
Build-to-Suit
Either
 
Lease
Own
Either
 
Hi-image
Average
Mfg ft.
Warehouse ft.
Office ft.
TOTAL ft.
Min. Ceiling Ht.:
Dock Doors
yes
no
Electric
yes
no
Water
yes
no
Wastewater
yes
no
Proximity Base to Supplier
Raw Materials
Key Competitiors Location
Rail
Interstate
Airport
Waterway
International
National
Regional
Local
University
Vo-Tech
Public Schools
Private Schools
 
 
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