XPlatform Consulting - Questionnaire

MOMENTUM Coaching + Consulting

This brief form is used to get a better understanding of the service(s) requested from you as a potential client. If any of the the questions do not apply to your particular request please mark as N/A. We look forward to working with you and/or your organization.
Full Name*

First NameLast Name
Company Name
Email*
Phone Number*

Area CodePhone Number
PROJECT OVERVIEW
What service are you requesting?*

1 on 1 Coaching (Life or Career)Group Coaching (Career)Interim Senior/Executive Leadership (nonprofits)Corporate ConsultingPlanning + StrategyFundraising Campaign + Development AssessmentProject ConsultingEvent ManagementWorkshop or Speaking EngagementThe Shero Plan
What is the length of time requested?*

Keynote or Panel Discussion3 months or less3 months or moreOther
If this is a workshop or speaking engagement request, please select the topic area(s):

LeadershipWomen & Girls EmpowermentDiversity, Equity, and InclusionGrassroots FundraisingCommunity Power Building and OrganizingWellness and/or Mental Health AwarenessSports BusinessOther
Please describe your intended target audience.*
How many attendees do you expect? Please indicate the number if it is more than 100.*

10-2525-5050-7575-100100+Other
Will audio/visual equipment be available for a presentation deck?*

YesNoOther
What is the estimated budget for this project?
Please write n/a if there is no established budget.
Phase 1- Estimated Project Start Date

MonthDayYear
Phase 1 Description:
Phase 2 - Estimated Project Completion Date

MonthDayYear
Phase 2 Description:
Should be Empty:

MOMENTUM Coaching + Consulting

PROJECT OVERVIEW