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VLI Consultation Request
Name
Contact Telephone number
E-mail address
Zip code
Which office or leadership position might interest you?
What specific questions do you have about pursuing a higher leadership position?
What specific political or leadership experiences have you acquired?
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
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
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
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
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
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
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
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
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
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
Excellent
Clear selection
If you scored yourself under a "5" for any of the above skills, please provide an explanation below.
Which times/days work best for a consultation via phone in the coming weeks?
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