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consultants in organization effectiveness
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Referral Candidates for Vistage Membership Name: ________________________________ Title: ________________________ Company/Organization Name: ___________________________________________ Address:________________________________________________________________ City: ___________________________________ State: ______ Zip: ______________ Phone: __________________________________ Fax: __________________________ Email:__________________________________________________________________ Website:________________________________________________________________ Business Description:______________________________________________________ _______________________________________________________________________ Sales: ___________ # of Employees: ____________ Nominated by: ________________________________________________________ Phone: ______________________ Email: _____________________________________ Has the candidate had some introduction to Vistage? _____Yes ______No Level of interest – check one _____ Unknown - just passing along a name (not a desirable way - but, hey - I'll take it!)_____ Curious – wants to discuss a little more before moving forward _____ Interested – wants to meet for a Telling Session (45 minutes) to learn more about Vistage and benefits of membership, costs, logistics _____ Knows fair amount about Vistage (source _______________________) and wants to schedule a Selection Interview (90 minutes). At the end of the selection Interview, we should be positioned to make a mutual decision regarding membership. _____ Very interested – wants to attend meeting as guest to meet other members and experience first hand. _____ Other:____________________________________________________________ Next Step - check one _____ Gil should contact candidate by _______________________ (date)_____ Candidate will contact Gil by ______________________(date) _____ I will set up a time with myself, candidate, and Gil to get together by __________________ (date) Remarks:
Thank you for this referral. I'll keep you posted on progress. Gil |
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