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*Name

*Organization Name

*Email

*Phone Number

What is the mission of your organization?

What are the top 3-4 business priorities your organization is focused on at this time?

Why are you interested in diversity consulting or diversity education at this time?

How will you know your investment in diversity consulting or diversity education was worth the time and money devoted to it?

What are the EEO demographics in your organization?

What additional demographics are available?

On a scale of 1-10 (with 10 being excellent), how do you think the following groups from your organizationwould rate on commitment to diversity?

? 1 2 3 4 5 6 7 8 9 10 Executives and senior leaders
? 1 2 3 4 5 6 7 8 9 10 Managers and supervisors
? 1 2 3 4 5 6 7 8 9 10 Non-supervisory employees
? 1 2 3 4 5 6 7 8 9 10 Customers
? 1 2 3 4 5 6 7 8 9 10 Suppliers and/or Industry colleagues

What other diversity-related initiatives and activities have been introduced or implemented in your organization? (and what was the response)