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VLI Consultation Request
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Name
Your answer
Contact Telephone number
Your answer
E-mail address
Your answer
Zip code
Your answer
Which office or leadership position might interest you?
Your answer
What specific questions do you have about pursuing a higher leadership position?
Your answer
What specific political or leadership experiences have you acquired?
Your answer
How would you rate your PROFESSIONAL AND PERSONAL NETWORK on a scale of one to 10?
For anything under 5, please provide an explanation of why in the next section.
Poor
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Excellent
Clear selection
How would you rate your CAMPAIGN EXPERIENCE AND SKILLS (including FUNDRAISING) on a scale of one to 10?
For anything under 5, please provide an explanation of why in the next section.
Poor
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Excellent
Clear selection
How would you rate your POLICY KNOWLEDGE on a scale of one to 10?
For anything under 5, please provide an explanation of why in the next section.
Poor
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Excellent
Clear selection
How would you rate your COMMUNITY LEADERSHIP AND INVOLVEMENT on a scale of one to 10?
For anything under 5, please provide an explanation of why in the next section.
Poor
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Excellent
Clear selection
How would you rate your NAME RECOGNITION/BRAND on a scale of one to 10?
For anything under 5, please provide an explanation of why in the next section.
Poor
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Excellent
Clear selection
How would you rate your INFLUENCE on a scale of one to 10?
For anything under 5, please provide an explanation of why in the next section.
Poor
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Excellent
Clear selection
How would you rate your EXECUTIVE PRESENCE on a scale of one to 10?
For anything under 5, please provide an explanation of why in the next section.
Poor
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Excellent
Clear selection
How would you rate your EDUCATION on a scale of one to 10?
For anything under 5, please provide an explanation of why in the next section.
Poor
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Excellent
Clear selection
How would you rate PUBLIC SPEAKING EXPERIENCE on a scale of one to 10?
For anything under 5, please provide an explanation of why in the next section.
Poor
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Excellent
Clear selection
How would you rate YOUR FUNDRAISING EXPERIENCE on a scale of one to 10?
For anything under 5, please provide an explanation of why in the next section.
Poor
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Excellent
Clear selection
If you scored yourself under a "5" for any of the above skills, please provide an explanation below.
Your answer
Which times/days work best for a consultation via phone in the coming weeks?
Choose
Weekdays between 9am and 5pm EST
Weekdays between 5pm and 8pm EST
Saturdays and Sundays between 8am and 8pm EST
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