1. Product / service name:

2. Type of industry:
A. Fashion and Clothing  
B. Health and beauty  
C. Food and beverages  
D. Education and training  
E. Profesional Services  
F. Financial Services  
G. None in this list
3. Business Location:
A. Perak/Kedah/Pulau Pinang/Perlis  
B. Kelantan/Terengganu/Pahang  
C. Kuala Lumpur/Selangor/Putrajaya  
D. Negeri Sembilan/Melaka/Johor  
E. Sabah/Sarawak/Labuan  
F. Singapura/Brunei/Indonesia  
G. Lain-Lain
4. Company name:

5. Years in business:

6. Type of company:
A. SDN BHD  
B. ENTERPRISE  
7. Role in the company:
A. Founder / CEO / Managing Director  
B. Director Stockist / Agent/ Dropship  
C. Manager Company  
D. Consultant / Professional Services/ (Architect, Auditor, Doctor, Lawyer, etc)  
8. Instagram business:

9. Facebook business:

10. No of staff:
A. None  
B. Less than 5 people  
C. 5-20 people  
D. 20-50 people  
E. 50-100 people  
F. More than 100 people  
11. No of Agent:

12. No of Stockist:

13. No of Dropship:

14. Jualan bulanan anda (purata):
A. Kurang RM5,000  
B. RM5,000 - RM10,000  
C. RM10,001 - RM30,000  
D. RM30,001 - RM50,000  
E. RM50,001 - RM100,000  
F. RM100,001 - RM 1 Juta  
15. Total sales in 2019 (RM)?

16. Total sales in 2020 (RM)?

17. What is your current occupation?
A. Self employer with full time business.  
B. Employer with part time business.  
18. What is your main roadblock in business?
A. Sales  
B. Leadership  
C. Compliance  
D. Operation  
19. Why do you want to be part of SPIRE Circle?


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