Self-Assessment Form & Action Plan

Self-Assessment Form & Action Plan

Please indicate which one of the above referral agencies you would like to use:

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First/Last Name: ＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿

1. Why are you interested in being self-employed
(Check the three most important points, in order of priority 1, 2, 3)

To be my own boss

To be independent

To work irregular hours

To work at home

To work in an area that I enjoy

To run a family business

To earn a good income

To continue to care for my
family while I work

To get off employment
insurance/welfare

Other reasons:

2. What help would you need in order to become self-employed
(Check (√) all that apply.)

Training in how to start
a business

Training in how to manage a
business

Training in a specific skill (explain):

Help in making business contacts

Help with building self-confidence

One-on-one business counselling

Personal counselling (family
problems, stress, etc.)

Help in finding money for start-up costs

Child care assistance

Continued financial assistance
while starting a business

Bookkeeping

Computer skills

Other reasons:.

[hwp/doc/pdf]Self-Assessment Form & Action Plan