Amper Counsel Program
1.

Please enter the information indicated below.
First Name:
Last Name:
Job Title:
Company Name:
Work Phone:
Email Address:
emailaddress@xyz.com
Address 1:
Address 2:
City:
State/Province
(US/Canada):
Postal Code:

2.

Are you a PA or NJ based/headquartered business? (Must be in order to qualify)
PA
NJ
3.

How many owners of record in your company?  (Must be 10 or less to qualify)

 

  • 50 characters left.
4.

Are you privately owned?  (Must be privately owned to qualify)
Yes
No
5.

How much were your revenues last year? (Must be between $1M to $100M to qualify)
 

  • 50 characters left.
6.

How many employees do you have? (Must be less than 200 employees to qualify)
 

  • 50 characters left.
7.

What industries are you in? (Must be included in one of these selections in order to qualify) - Check all that apply
Manufacturing
Distribution
Professional service providers (physicians, law, marketing, engineering)
Automotive Dealership
Services (Healthcare, Food Services)
Real Estate
Technology Companies (software developers, clean technologies)
Other  
8.

Check the areas of assistance needed
Taxes - Any Type
Accounting concerns
Company Retirement Plans
Fraud in The Workplace
Employee
Estate Planning
Business Insurance
Employee Benefits
Employee Vs Independent Contractor
Other  
9.

How would you say you maximize the use of your current accounting firm?
 

  • 50 characters left.
10.

What the specific challenges do you have that you would like to address?
 

  • 350 characters left.
11.

Tell us how specifically you expect this assistance to help you.
 

  • 350 characters left.