Customer Needs Assessment Form
Thank you for choosing Cultural Connections by Design™ (CCBD) for your diversity education needs. If you have general questions, please email us directly at Please allow 10-15 minutes to complete the following, as the information you provide on this Customer Needs Assessment Form will help us prepare for our initial meeting. We look forward to learning more about your organization so we can provide the best diversity education experience possible.
Email address *
First Name *
Your answer
Last Name *
Your answer
Your answer
Phone Number *
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How did you hear about us? *
If you selected referral above, please indicate who refered you.
Your answer
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