Request a Private Thirty-Minute Board Call

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To find out whether your organization is ready for a Private Thirty-Minute Board Call, fill out the application below and we will get back to you within one week to schedule a call or to let you know what other steps would need to be completed before scheduling a call.

Fields with an asterisk (*) must be completed.

Name of Organization:*
First Name:*
Last Name:*
E-mail Address:*
Phone Number:*
City:*
State/Province:*
Zip/Postal Code:*
Country:*

1. Does your organization have a serious interest in the two-day Benevon^™ 101 Workshop?*	Yes No
2. What concerns will your organization have about the model and attending the Benevon 101 Workshop?*
3. How many people are on your board? (Note: You must enter a number.)*
4. Do you have a board member who is a champion for this model?*	Yes No
5. Is your CEO or executive director currently in support of the implementation of this model?*	Yes No
6. Will your CEO or executive director be on the call?*	Yes No
7. How many people will be on this call? (Note: You must enter a number.)*
8. Do you have any board meetings already scheduled in the next sixty days that this call might fit into?*	Yes No
9. If yes, please give dates and times with the time zone you are in. (NOTE: We do not guarantee availability of this time and date.)*
10. If no, are you open to scheduling something in addition to any set meetings you already have?*	Yes No

(Note: Benevon does NOT sell, rent, exchange, or give away any contact information. This information is strictly confidential.)