Information Request Form

Name:*

Organization:*

Title:

Address:

City:*

State:*

Phone:*

Fax:

Email:*

I prefer to receive:*
E-mail
Phone Call
Mail

I am requesting information about these services: (check all that apply)
Full Service Management
Outsourced Services
Advocacy
Communications & Public Relations
Conventions & Exhibitions
Education & Accreditation
Executive Management
Financial Management
Governance
Government Relations
Technology & Websites
International Outreach
Marketing & Branding
Membership Recruitment & Retention
Revenue Development
Strategic Planning

I would like further information as described:

Please complete this section so we can provide appropriate information.

My organization is an:
Association
Corporation
Other

My organization is currently:
Self-managed
With a management company
Contracting brokered services
Other

My organization's focus area is:
Medical/Health Care
Professional Society
Trade Group
Other

My organization's size is:
less than 1,000
1,001 to 5,000
5,001 to 10,000
more than 10,000

My organization's membership is:
International
National
Regional
State
Local

My organization's annual budget is:
less than $250,000
$250,000 to $500,000
$500,000 to $1 M
$1 to $3 M
$3 to $5 M
more than $5 M

I am preparing a request for proposal (RFP):
Yes
No

How did you learn about EAI?:
Web Search
Referral
ASAE Guide to AMC's
AMC Institute
Other

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