2017 PCT Top 100 Entry Form Question Title * 1. Contact Information Your Name Your Title Company Name Street Address City/Town State/Province ZIP/Postal Code Phone Fax E-Mail Address Question Title * 2. What is your company's website address? Question Title * 3. How many offices does your company have? Question Title * 4. What percentage of your business is commercial vs. residential? (total should equal 100%) Residential Commercial Question Title * 5. What were your total revenues in 2016 (January to December 2016) Question Title * 6. What percent change in your firm's revenues was there from 2015 to 2016? Increased by ____% Decreased by ____% No change Question Title * 7. We anticipate a ____% increase/decrease for 2017 (please include + or - symbol). Question Title * 8. Please indicate the percentage of your overall business in the following categories (total should equal 100%). General Pest Control _____% Termite Control _____% Turf & Ornamentals _____% Other _____% Question Title * 9. If you offer termite control, break down your offerings (total should equal 100%): Pre-Treats _____% Post-Construction _____% Question Title * 10. Please indicate the number of employees in the following areas: General Pest Control Technicians Termite Technicians Universal Technicians Total Number of Employees Question Title * 11. What is the name of the individual holding each of the following positions: Owner President General Manager Technical Director GPC Manager WDI Manager Purchasing Director Marketing Manager Sales Manager Done