SECTION 1 — Contact Info
First Name
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Last Name
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Phone Number
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Email
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Organization Name
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Website
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Address
Street Address
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City
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State
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Country
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Country
Postal Code
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How did you hear about this opportunity?
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SECTION 2 — Foundation & Revenue Profile
1. How long have you been in business, and what problem do you exist to solve?
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2. Average Transaction Size (Select One):
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Select average transaction size
3. Primary Revenue Structure (Select One):
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Select primary revenue model
4. Annual Revenue Capacity (not current revenue, but realistic ceiling within current model) (Select One):
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Select realistic revenue ceiling
5. What percentage of your revenue is recurring or contractually secured? (Select One):
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Select percentage of recurring revenue
SECTION 3 — Operational Maturity
6. Which best describes your internal systems? (Select One):
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Select operational maturity level
SECTION 4 — Quality & Integrity Standard
7. When forced to choose, what defines your company most? (Select up to two):
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Select up to two
8. How do you personally engage with your own product or service? (Select One):
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Select engagement level
If not actively using it, briefly explain why:
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SECTION 5 — Strategic Fit & Alignment
9. Do your customers or facilities have a potential need for energy optimization (cost reduction, power quality, EMF mitigation)? (Select One):
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SECTION 6 — U-ACT Movement Involvement
10. At what level would you participate in U-ACT if aligned? (Select one):
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Select involvement level
SECTION 7 — Vision & Stewardship
11. If capital and resources were not the constraint, what long-term impact would your business pursue? Short answer (300–400 characters max)
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SECTION 8 — Network Leverage
12. Who in your network should also be considered for CPL representation or U-ACT involvement? Short answer (Name + Company + Role)
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