Prospective Client Questionnaire
PRIVACY:  Your organization's privacy is important to us.  Becoming Better Together agrees not to share any information collected within this survey and will only use the information for the purposes of developing a scope of work specific to your organization and its needs.
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Email *
Organization name: *
Your name: *
Phone Number *
What is the primary change you want to see within your organization and what support are you looking for? *
Why do you / does your organization want to engage in this work right now? *
When would you ideally like to start an engagement? *
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How long do you anticipate the engagement will last? *
When do you need to complete this engagement? *
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/
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/
YYYY
Do you have any flexibility with the start date or timing of completion? If so, please share any information that would be helpful in our planning. *
What is your budget for this engagement? *
How many total employees does your organization have? *
How many people from your organization do you anticipate will be involved in this engagement? *
What commitments to diversity, equity and inclusiveness has your organization made? *
How have your organization's senior leaders demonstrated their level of commitment to equity? *
What are the racial and gender demographics of your organization? *
What is the racial and gender distribution across roles within your organization (e.g. CEO, managers, coordinators, etc.)? *
What can you share with us about employee engagement (satisfaction, retention, promotion, etc.)? *
Based on our organization's employee engagement scores, most people find our organization to be: *
What has your organization done to develop a shared language and understanding of the terminology related to diversity, equity, and inclusiveness? (Check all that apply.) *
Required
Our organization has checks and balances to ensure fair processes and equitable access to opportunity as it relates to: (Check all that apply.) *
Required
Our organization actively works to interrupt systems of oppression within: *
Strongly disagree
Disagree
Agree
Strongly agree
The terminology of systemic oppression is unfamiliar to our organization
Our country
Our organization
Our teams
Ourselves and between people
Our organization explores social identity, intersectionality, and how those impact interactions at work. *
How did you hear about us? *
Anything else you'd like us to know? *
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