Request Retainer Fee

Small Business Consulting Services

Business Assessments... Business Planning Services... Consulting Services...
Mentoring Programs... Business Skills Training

Quotation Request for the

Legacy Retainer Fee Schedule

Fast Track Quotation Request
for the
Legacy Small Business Consulting Retainer Fee Schedule

THE INFORMATION YOU SUBMIT IS FOR QUOTATION PURPOSES ONLY...
BY SUBMITTING THIS FORM YOU ARE UNDER NO OBLIGATION TO
PURCHASE ANY SERVICES FROM LEGACY ASSOCIATES, INC.

In order to properly assist you, we require the following contact information from you. Also, you must forward a complete copy of your existing business plan to the e-mail address provided below. Providing complete details allows us to more quickly and more accurately respond to your request.

*Required

	Did you read the Legacy Confidentiality Agreement? *	Yes
		No
	Contact Information
	Your First Name: *
	Your Last Name: *
	Your Title:
	Legal Name of Business: *
	Your Telephone Number: *
	Your Mobile Number:* Your Fax Number: Your E-mail Address: *
	Background Information
	List Your Top 3 Business Issues/Challenges for 2010: * Sales Revenue for 2009: * Number of Employees: * Year the Business was Established: *	Enter comments here!

Please note that the information you submit to Legacy Associates, Inc. will be kept confidential.

The information will be used only for the purpose of preparing a quotation for the
service that you expressed an interest in. BY SUBMITTING THIS FORM YOU ARE UNDER NO OBLIGATION TO PURCHASE ANY SERVICES FROM LEGACY ASSOCIATES, INC.

You can view as well as download a copy of our Confidentiality Agreement here.