Title (Mr., Ms., Dr., etc.):

First Name (Required):

Last Name:

How did you hear about this survey?
i.e. e-mail from Lee, Google, Craig's List,
e-mail forward <Please include their name>,
SLC-A Newsletter, Other SLC-A Contact,
Business Catalyst Website,, etc.

IN CASE WE HAVE QUESTIONS                  

Your e-Mail Address (Required):

Verify Your e-Mail Address (Required):

Your Cell Phone Number:

Your Work Phone Number:

DEMOGRAPHIC INFORMATION                  

Home Location (Area Only):

Notes on Home Location:


Job Title:

Please Describe Your Role/Function:



Time in Role AT THIS COMPANY:

Total Years in this Role or Field:

Challenges You Face in this Role:



Where to YOU want to be in 10 Years?

ABOUT YOUR ORGANIZATION                    

Organization's Name:

What Does Your Organization Do?



Organization's Location (Pick One):

Notes on Location:


Number of Employees TOTAL:

Number of Employees Here:

Roughly, Past Year's Annual Revenue:

Organization's Biggest Challenge:



Where to you want your organization
to be in 10 years?

PROFESSIONAL DEVELOPMENT NEEDS   

Starting Your Own Business:

Developing a Business Plan:

Funding/Financing Your Business:

Influencing and Leading Others:

General Management Practices:

Understanding Finance/Accounting:

Legal Issues in Business:

Designing and Developing Organization:

Recruiting/Employee Development:

Marketing and Market Development:

Sales and Business Development:

Improving Cash Flow (Profit,
Revenue, Bottom Line, etc.):

Networking with Other Business People:

Networking with Business Leaders:

Providing Excellent Customer Service:

Time/Self Management:

Your Own Personal Development Plan?

Integrating Work, Family, Friends,
Beliefs, etc.:

Finding a New or Better Job:

Other Areas You REALLY Need:
(Please, tell us what we forgot
that is important to you)

Other Areas of Interest?
Optional, but, please complete so we can get back to
you with any questions...
Months
Years
Years
SCHEDULING QUESTIONS... Help us understand WHEN the best time to offer training would be...
You have told us where and what, now share your thoughts on when...

Our training and networking events can range from 1 hour to 5 days in length and we can run them on any day
of the week.

WHAT DAY(S) and TIME(S) would be best for you to attend - check all START TIMES that would work?
MONDAY
 TUESDAY
 WEDNESDAY
 THURSDAY
 FRIDAY
Any Time
Early - 7:00 am
Early - 8:00 am
Lunch - 11:30 am
Afternoon - 4:00 pm
Afternoon - 5:00 pm
Evening - 6:00 pm
Evening - 7:00 pm
SATURDAY
SUNDAY
Any Time
Early - 7:00 am
Early - 8:00 am
Lunch - 11:30 am
* Early Afternoon - 1:00 pm
Afternoon - 4:00 pm
Afternoon - 5:00 pm
Any Time
Lunch - 11:30 am
* Early Afternoon - 1 pm
Afternoon - 4:00 pm
Afternoon - 5:00 pm
Evening - 6:00 pm

* Not Offered on Weekdays
Your Additional Thoughts or Comments on Scheduling...
May we call you to get more clarity on your answers?
(If Yes... Please be sure your phone number is included at the top.)

May we e-mail you to get more clarity on your answers?
(If Yes... Please be sure your e-mail address is included at the top.)

May we add you to our Professional Development e-Newsletter?
(If Yes... and you don't like it, you can always "Opt Out" after you review it.)
Your Closing COMMENTS and/or Suggestions
Your input and opinions are valuable to us.  Please share your thoughts on this survey or any other topics
here.  Thank You!
Referrals
If you know of someone else who would provide good input on this survey or who may be interested in this type
of training, you may send this link to them in e-mail or you can provide their names and e-mail addresses here
and we will be in touch with them.  Thank You!
Name:
 e-Mail:
Name:
 e-Mail:
DO NOT FORGET TO HIT THE SUBMIT BUTTON =>
              Professional Development Needs and Interests Survey

Welcome! and Thank You! for visiting with us.  

This in depth survey is designed to gather your input on your Professional Development needs as a Business
Owner, Executive, Community Leader, or Team Member.  Any specific contact information your provide, that is
anything that could identify you, will only be looked at by the person who summarizes the data and our CEO, Lee
Huffman.  So, feel free to answer any questions below with confidence that your information will not be shared or
compromised.  Also, feel free to skip any questions that you don't feel like answering.  We want you to feel
comfortable providing the data that you do provide to us.  There are only three required fields on this form.  
Everything else is option, but would be greatly appreciated.

If you want to read a more detailed explanation regarding
this survey before you fill it out, please click here ->