Request a Customer Advisor
This is a form for the Business Development Director's to request engagement with a Customer Advisor. There is no guarantee that you will get the date or advisor you requested, but we will work hard to ensure the best alignment for the output desired.
Your email address:
Customer Referral – Speaking with potential clients or colleagues on campus
Customer Advocacy – Speaking at conventions and event, case studies, thought leadership, media outreach
Based on the above, what is the specific activity being requested (if it is an event or connect with an additional customer, please provide detail on contact, dates, location, etc.)?
Request Activity Date
Role Type Requested
Please provide detail on specific outputs - what is the purpose of this engagement?
In Person Presentation
Case Study/White Paper/Success Story
Customer Advisor Preferred
Dr. Charlene Spearen, VPAA, Allen University
Neale Adams, Dean of Business, Iowa Central
Dr. Ryan Tipton, Provost, University of the Southwest
Maddie Caballo, VP of Allied Health, Arizona College
Connie Allison, Executive Director, Center for Academic Development, Liberty University
Dr. Marianne Van Deursen, VPAA, Warren County CC
Dale Pinzino, Director, University Bookstore, University of Wisconsin, Whitewater
Dr. Ryan Ruda, President. Garden City CC
Dr. Will Austin, President, Warren County CC
Nikki Fox, Director of Online & Academic Affairs, Concorde Career College
Stacy Phipps, Director, Porterville Adult School
Dr. Betty Young, President, Hocking College
How would you like us to make the connection?
I would like you to connect my prospect directly with the selected CAN member
I would like you to connect ME with the CAN member and I will connect them to my prospect
Please name the account to which this request should be applied.
Never submit passwords through Google Forms.
This form was created inside of Cengage Learning US.