Questionnaire for Hydroponic Lettuce Business Plan - DOC

							            Questionnaire for Hydroponic Lettuce Business Plan
   Please fill out as completely as possible. Please type or print very clearly. Be specific and feel free to add any further
                      information you think helpful or that you may want included in your Business Plan.


Your Name:

Address:

City, State, Zip:

Phone:

email:


Have you had any experience in hydroponics, greenhouse vegetable production, horticulture, or agriculture of any kind?
q Yes q No      If yes, describe:



Have you attended CropKing’s Grower Training Workshop?       q Yes q No

Proposed company name:



Describe and include any logos, trademarks, etc., that are associated with your company name:


Is the company:     q Proprietorship q Partnership q Corporation   Date company was begun:



If your company has been in operation prior to now, include basic company information and history:


Furnish information below regarding all other principals (if you have any outside directors or advisors, please list names, addresses,
and phones)

NAME:                                                  ADDRESS:                                                    PHONE:




Your current annual income:

Other business interests, describe:

Real estate owned (market value):

Amount owed on real estate:

How much cash will you contribute to the project?:


List names of those who will be working with you, and any special skills or education that they may have:

NAME:                                                  SPECIAL SKILLS / EDUCATION:




Are there any hydroponic facilities near you?   q Yes q No    If yes, give name and address, size of greenhouse, and crops grown:
Location and address of your proposed greenhouse facility:

Your city / town:                                                                      Population:

Nearest city to you:                                                                   Population:

County you live in:                                                                    Population:

Estimate population for 50 mile radius of site:

Describe your market area (city, rural, upscale, etc.):



List the grocery stores and supermarkets in your town, and then in the surrounding 50 mile radius. If a chain, number of stores:


Do any of the stores in your market area handle hydroponic lettuce now?     q Yes q No         If yes, what prices are they selling for at

retail? Low                                                                            High


Enter the retail prices for regular field lettuce during the following months. Be sure to include range from lowest to highest:

   Mar                         Apr                          May                          Jun                           Jul

   Aug                         Sep                          Oct                        Nov                             Dec


Greenhouse size (choose one greenhouse, one size only):
    q Freestanding, size:
    q Gutter Connect, number of bays ; size:


Heating fuel (type and cost): Will you be heating with    q LP (propane) q Natural Gas
 q LP Gas; cost per gallon
 q Natural Gas; cost per 1000 cu.ft.
 q Electricity cost per KWH


We will be doing an annual cash flow using three variables. Please provide below the wholesale prices that you wish us to use in the
business plan.
Wholesale Price Per Head, for variable: #1                      #2                       #3

What percentage of your crop do you plan to sell in retail crispers:   %; in bulk:   %
Will you hire labor to construct the greenhouse?  q Yes q No
Will you hire an electrician to wire the greenhouse? q Yes q No

Will you use conduit for your electrical wiring?   q Yes q No
Do you plan to use floor heating?  q Yes q
Do you plan to install concrete walkways? q Yes q No

Will you use perimeter insulation? q Yes q No

Climate:
    What is your normal low temperature in the winter?

    What is your normal high temperature in the summer?

At what elevation (feet above sea level) will your greenhouse be located?
Estimate cost to bring utilities to greenhouse:

    Electric:

    Gas:

    Water:

Estimate cost of preparing your site for the greenhouse:



Notes, additional comments, or specifics about your particular situation:


Will you be using CropKing’s Homestead Family Farm marketing program?          q Yes q No

• Provide sketch of property and greenhouse site (include buildings, trees, etc.); indicate North in upper left corner.

• If you have questions about any of the items on this questionnaire, please contact us. It is extremely important to provide all of the
  information requested. Please be very specific and detailed when answering the questions.

• Be sure to fill out the following resume form as well, including one for each of the key people working with you in this project.
  Providing a resume is critical to completing the Business Plan.



I (type or print name),                                                             , authorize CropKing to complete a Business Plan

based on the information provided. I agree to pay the $495 fee for the completed Business Plan.



Signature                                                                           Date


           CropKing Inc., 5050 Greenwich Rd., Seville, OH 44273-9413, phone 330-769-2002, fax 330-769-2616
                               email: cropking@cropking.com  http://www.cropking.com
Resume for Business Plan
Your Name:
Address:
City, State, Zip:
Phone:                                                         email:


EDUCATION (College or vocational schools as well as any other educational programs you may have completed):




WORK HISTORY (Jobs you’ve held for the past ten years, beginning with the current, or most recent):




EXPERIENCE (Type of work you’ve done in the jobs listed, as well as any skills or knowledge and how you’ve applied it):




ACHIEVEMENTS (Any special achievements you’ve accomplished, either related or unrelated to your work):




PERSONAL (Married or single, family status, age if desired, associations or clubs, hobbies, etc.):