In order to better understand who you are and how KGA can best serve you, we have prepared a brief profile questionnaire. Please take a minute to complete the following questions to help us address your needs more efficiently and effectively. Thank you.

Name

Title

Organization

Address

City State  Zip
  
Telephone

E-mail

What type of organization do you represent?

Community Group
Non-profit Organization
Educational Institution
Private Sector (Small Business)
Private Sector (Larger Corporation)
Industry Association
None (Individual)
Other

What is the membership of, or number of employees in your organization?

Less than 25
25 - 99
100 - 499
500 - 999
1,000 - 4,999
5,000 - 9,999
Greater than 10,000

What type of service(s) do you anticipate needing from KGA?

Executive Education/Training
Consulting
Presentation (Public Speaking)
Materials (Print or Video)
Other

How can KGA serve you?

I would prefer to be contacted by Email Telephone Postal Mail Any Method     

We will respond to all inquiries as quickly as possible.

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Kevin Gottlieb & Associates, Inc.
P.O. Box 3240
Annapolis, MD 21403-0240
(301) 858-5101 tel
gottliebk@mindspring.com