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Kuumba Collective Service Inquiry Form
Thank you for considering Kuumba Collective as your chosen collaborative partner! We look forward to conversing about you and your business needs. Please complete this form and one of our Masterminds will contact you soon.
Feel free to contact us anytime via email (
info@kuumbacollective.com
) or phone (612-900-0553).
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Primary Contact Information
First Name
*
Your answer
Last Name
*
Your answer
Contact Preferred Email
*
Your answer
Contact Preferred Phone
*
Please enter the phone number, including area code, which you will like to be contacted.
Your answer
Best time(s) to call
Select the best day(s) and time(s) to call and discuss your business needs.
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Morning (7 am - 11 am CST)
Midday (11 am - 2pm CST)
Afternoon (2 pm - 5 pm CST)
Evening (5 pm - 8 pm CST)
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Morning (7 am - 11 am CST)
Midday (11 am - 2pm CST)
Afternoon (2 pm - 5 pm CST)
Evening (5 pm - 8 pm CST)
Company/Organization Information
Company/Organization Name
*
Your answer
Company/Organization Address
*
Enter the full Street Address for the company/organization headquarters or primary office. Include the City, State, and Zip Code. Write n/a if not applicable.
Your answer
Primary Company/Organization Phone
If the primary company/organization phone is different than the preferred contact phone listed above, list here. Include area code.
Your answer
Primary Company/Organization Email
If the primary company/organization email is different than the preferred contact email listed above, list here.
Your answer
Company/Organization Website
Your answer
Business Industry
*
Choose the industry your business operates within. Check all that apply.
Arts, Entertainment, and Recreation
Business Management, Leadership and Administrative Services
Education & Youth Services
Faith-Based or Religious Organization
Health Care & Social Assistance/Services
Personal Services
Professional, Scientific, and Technical Services
Public Administration
Other:
Required
Service Inquiry
How can Kuumba Collective assist you in reaching the next level?
*
Tell us a little bit about your project/business needs and how you will like us to assist.
Your answer
What services might your company/organization benefit from?
*
Check the services that may be beneficial now and in the future.
Business Development & Growth Services
Strategic & Action Planning Services
Participatory Action Research & Engagement Services
Training, Workshop or Program Design Services
Social Enterprise Development Assistance
General Consultation
Facilitation & Hosting
Other:
Required
What area of expertise will be the focus of our work together?
*
Check all that apply.
Youth Development
Mental Wellness
Community Engagement
Diversity, Equity, Inclusion
Other:
Required
What is your budget for your project?
*
Our service pricing is flexible and we strive to develop a service proposal to fit your budget. Ranges are ok!
Your answer
Additional Comments
Provide any additional information that you will like us to know.
Your answer
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