Name: Title: Organization: E-mail: Phone: What time of day should we try contacting you? Early morning Mid-morning Lunch hour Early afternoon Mid-afternoon Late afternoon/early evening Late evening Anytime   Do any of the following describe your situation? (mark any that apply) We've come to an impasse on an issue We need to know what citizens think We want to increase citizen participation We need lessons in collaboration We need to reach out to a specific group We have a controversial issue We need a facilitator to conduct a meeting We want to increase communication among groups We want to empower citizens to solve problems We need assistance with strategic planning We have a grant that requires citizen input None of the above   What services are you interested in? Meeting facilitation Online engagement Online surveying Stakeholder engagement Public/citizen engagement Strategic planning Interactive collaboration activities   Optional: Briefly describe your situation. Do you have other concerns or comments?