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First name
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Last name
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Email
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Phone
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Organization / Company Name
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Your Role / Title
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Preferred Pronouns (optional)
What services interest you the most? (Check all that apply.)
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Inclusive Learning Strategy
Instructional Design & Course Development
Leadership Development Training
Multigenerational Workforce Consulting
Organizational Development
Train-the-Trainer Programs
Other:
Other: [Describe ]
Briefly describe the challenge you're trying to solve or the outcome you're seeking.
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Who is your target audience? (Check all that apply)
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Executive Leadership
People Managers
General Workforce
Frontline/Hourly Staff
DEI Practitioners
Other: (Describe Below)
Other:
Have you worked with a learning or DEI consultant before?
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Yes
No
How would you describe your organization’s approach to inclusion and learning today?
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Do you have any specific accessibility or cultural considerations you'd like us to keep in mind?
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What’s your preferred method of communication?
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Email
Phone
Zoom/Video
Ideal start date for services:
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Do you have a budget range allocated for this work? (Optional but helpful)?
How did you hear about EmpowerHER Strategies LLC?
Other:
Is there anything else you'd like to share with us before we connect?
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