Application Questionnaire
Contact Information:
Firm Name:
Principal Address:
Telephone: FAX:
Website: Additional Offices? Yes No
If yes, please list:
Is your website available
in English? Yes No
Office hours:
Does your reception
staff speak English? Yes No
What other languages are
spoken in your firm?
Managing Partner:
Primary Contact (Name, Title):
Email Address for Primary Contact:
Administrative Contact (Name, Title):
Email Address for Administrative Contact:
About Your Firm:
1. Date Firm Was Founded:
2. Brief history about your firm:
3. Firm Services:
4. Is the firm licensed to practice by the appropriate government and/or professional authorities? Yes No
5. If yes, please list the licensing authorities:
6. Are the principals licensed to practice by the appropriate government and/or professional authorities?
Yes No
7. Please provide full details of which principals are members of which bodies:
8. Is there any litigation or other threat to your business or to any of your partners? Yes No
a) If yes, please provide details:
9. List the top five sectors your firm services:
a)
b)
c)
d)
e)
10. Do you have a niche in any of the following industries:
11. Auto Dealers
Community Banking
Construction
Healthcare
Manufacturing
Nonprofits
Real Estate
12. List any previous or current memberships of other national/international associations of professional firms:
Statistics on your firm:
13. Staff Size: As of the date of this application, we currently have:
a) Shareholders, partners, owners (equity)
b) Number of all other professionals (excluding a)
c) Number of all other full-time personnel (excluding all of the above)
FIRM TOTAL
14. Year-end:
a) Last fiscal year-end date
b) Total net billings at that date
c) International work (if applicable)* – in US$ equivalent
· Countries involved in International work:
15. Practice Mix Please indicate service mix percentages for last fiscal year:
a) Audit and review services
b) Accounting services (compilation and write-up)
c) Tax services
d) Consulting and other management advisory services
e) Financial services
f) All other services TOTAL 100%
16. Hourly charge-out rates (average): Partner
Manager
Staff
17. Profiles. On separate sheets of paper, please provide a biography of the firm including primary services provided, bios of each management team member and a color photo in jpeg (.jpg) format for the member’s only section of the website.
18. Quality Control: Details of any peer review assessments/quality control procedures or staff training:
19. Professional Indemnity Insurance:
a) Are firms in your country required to hold professional indemnity cover? Yes No
b) If yes, what level of professional indemnity insurance cover does your firm have?
c) PLEASE SUBMIT COPY OF CERTIFICATE OF PROFESSIONAL LIABILITY INSURANCE COVERAGE WITH THIS QUESTIONNAIRE.
20. Referrals:
a) Number of annual international/interstate referrals:
b) Value of annual international/interstate referrals:
c) Are you likely to make referrals to Enterprise Worldwide member firms?
· To which countries?
Additional Details:
21. When would your firm like to join?
22. Please explain your main reasons for wanting to join Enterprise Worldwide:
23. How would you add value to the other members of Enterprise Worldwide?
24. Will your firm commit to taking part in the Annual EW Symposium and become an active member that collaborates with other member firms?
PLEASE SUBMIT A COPY OF YOUR MOST RECENT PEER REVIEW AS WELL AS A COPY OF YOUR PROFESSIONAL LIABILITY INSURANCE COVERAGE.
By:______Date:______
Printed Name:______
Please submit questionnaire to Adelaide Ness at