First Name:   Last Name:   
Company:    
Title:      
Department: 
Address 1:      
Address 2:      
City:          State:   Zip:    
Phone:      
E-mail:     
      

About Your Company

1. Select the type that best describes your company. Select Company Type Corporation Education Government Health/Medical High Tech Individual Professional Non Profit Professional Services Company Small Business Special Interest Community Trade Organization Utility Other If you selected Other, please specify. 2. Select the size (in revenues or sales) of your company. Select Approximate Size Less Than $50 Thousand $50-$99 Thousand $100-$250 Thousand $250-$999 Thousand $1-$10 Million $11-$100 Million Greater Than $100 Million 3. What products or services do you offer? 4. What is the target audience(s) for these products or services? 5. Do you currently have a web site? Yes     No If yes, please enter the URL (including http://) below. URL: 6. Do you currently have an Intranet (internal web pages, etc.)? Yes     No If yes, what is the purpose(s) or use(s) of your Intranet application(s).

About Your Program

1. Which of the following TBI formats would be appropriate to meet your requirements?     (Check all that apply.) Short talk or presentation Short seminar (1-3 hours) One-Day Seminar or Workshop Two-Day Seminar or Workshop 10-Week Course: UC Berkeley Extension 10-Week Course: Custom-designed program to augment internal (private)       organizational and corporate learning programs 10-Week Program: Custom-designed program to augment internal (private)       organizational and corporate operations, initiatives and projects 2. Select the ballpark budget for your program. Select Approximate Size Less Than $1 Thousand $1-$3 Thousand $3-$6 Thousand $6-$15 Thousand $15-$50 Thousand $50-$100 Thousand Greater Than $100 Thousand 3. What are the business objectives for your program? 4. About how many people will participate, and from what professional and     organizational backgrounds? 5. What is the approximate timing for your program? Start Date:      End Date: Start Time:      End Time: 6. What else should we know about your program requirements?

Just A Few More Questions

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