1.) What is the mission of your organization? What are the goals of your organization (long and/or short term?

2.) What are the strengths of your organization? What are areas for growth in your organization?

3.) How many members are in your organization? How many members do you expect to participate in our consultation or workshop?

4.) What are your reasons for requesting a consultation?

5.) What are your needs, goals and objectives for the consultation?

6.) Other comments/points of interest (use the back of this form if necessary):