FLORIDA’S HEARTLAND RURAL ECONOMIC DEVELOPMENT INITIATIVE
BUSINESS DEVELOPMENT SURVEY
This information will be used by Heartland Career Center and Florida’s Heartland REDI, Inc.
for Business assistance purposes.

Company Name: _________________________________________________________

Company Address:_____________________________ City:_______________________

Company Telephone:_______________________________________________________

Company representative surveyed: ____________________________________________

Number of Employees: Full Time: _____ Part Time: ____ Year Business Started:_________

Type of Business:_________________________________________________________

Product or Service: ________________________________________________________

Expansion possibilities:_____________________________________________________

Special Needs:____________________________________________________________

Hurricane Damage:_________________________________________________________ ________________________________________________________________________

Days Out of Business:_________________ Emergency Plan: □Yes □No

(Historically Underutilized Business) (Enterprise Zone) Workforce (One-Stop) HUB__________________________EZ______________Dev.______________________

Training or employee development needs:_______________________________________ _______________________________________________________________________

Business Development Needs: _______________________________________________ _______________________________________________________________________ _______________________________________________________________________

Do you currently have Wireless capability? □ Yes □ No If “Yes”, what do you use wireless for? _______________________________________________________________________
_______________________________________________________________________

Company Representative (surveyed):
Signature_________________________________________________ Date__________
                   Name                                                                  Title
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FHREDI Business Consultants Signature: ________________________________Date_________

Please mail completed form to:
Florida's Heartland REDI, Inc. Regional Office
P.O. Box 1196
Sebring, Florida  33871-1196