Nonprofit Health Strategy Call Application

Name*

First NameLast Name

Organization Name:*

Your title or role:*

E-mail:*

Best Phone Number:*

Area CodePhone Number

Website URL:*

What is your organization’s mission?*

What is your long-term vision?*

What are your organization’s top 3-5 goals?

1.

2.

3.

4.

5.

On a scale of 1 – 10, how difficult is it for you to achieve these goals? (1 = very easy, 10 = incredibly difficult)

Goal 1.

Goal 2.

Goal 3.

Goal 4.

Goal 5.

What do you see as the major challenges or struggles that are preventing you and your nonprofit from achieving your goals? *

Why is it important to solve the challenges described above?*

On a scale of 1 – 10, how committed are you to creating more efficiency, effectiveness and fundability and to finally position your nonprofit for ongoing success and sustainability? (1 = not at all committed, 10 = we’re ready to do whatever it takes!)*

	1	2	3	4	5	6	7	8	9	10

1 is Worst, 10 is Best