Client Intake Form Thank you for your interest in LifeOrganics Co. We look forward to working with you and helping your business flourish! Please complete all required fields (*) below. If it is not applicable, leave blank. First Name* Last Name* Email Address* Phone Number* Mailing/Shipping Address* City* State/Province/Region* Zip Code/Postal Code* Country* Business Information Business/Organization Name* Website URL Type of Business —Please choose an option—Sole-ProprietorLLCS-CorpC-CorpNFP Business Start Date: EIN Number: Sales Tax Certificate #:* Are you a partner of this company? YesNo What is your job title?* Are you specifically interested in organic product offerings? YesNo Give a brief description regarding the background of your company: Do you have a logo or established branding for your company? YesNo Please provide the mission/vision statement: What types of product(s) are you interested in?* Hair CareSkin Care Products & Services Which services do you currently need?* ConsultingFormulation (Product Development)Logo CreationLabel DesignLabel PrintingMarketing/BrandingIT/TechnicalAccounting/Financial (e.g. Profit Margin, Sales Projections)WholesalePrivate Label (e.g. New Products Expansion)Contract Manufacturing If you are interested in Private Label, would you need... Individual Bottles, Filled and LabeledIndividual Bottles, Filled (I have my own labels) If you are interested in Wholesale, would you need... Gallons (I’ll do everything else myself – I have packaging)5-Gallon Pails or 55-Gallon Drums (I just need the product!) Do you currently sell any bath, hair or skin care products?* YesNo If so, which ones? How do you currently sell your products? Haven't started yetOnly friends and familyWebsite/e-commerce platformAmazonEtsyOther Have you used, or do you currently use, private label through another company?* YesNo If yes, which company? Do you have or have you in the past made your own products?* YesNo If yes, which products? Other Information Do you have a business plan? YesNo Do you have a marketing strategy? YesNo Do you have a sales & distribution plan? YesNo Who is your target market? What is your anticipated budget?* —Please choose an option—$500-$1000$1000-$2500$2500-$5000$5000-$10000$10000-$25000$25000+ What is your time frame to purchase product or begin services?* —Please choose an option—Immediately1-3 months3-6 months6-12 months1-2 years How did you hear about us?* —Please choose an option—Yahoo!BingGoogleCurrent ClientOther Person What search term did you use? Who recommended you?