IMC Consulting and Training
901 Mchenry Avenue Suite A Modesto, CA 95350
Office: 209.572.2271 / Fax: 209.572.2862
E-mail info@imc-1.net


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Tell us a little bit about your business...

Business Name*			Years in Business
Contact			Title
Website			Number of Full Time Employees
First Name *			Last Name *
Daytime Phone*			Evening Phone
How did you here about us?	Phonebook	Banner or Ad		Friend	Referral
	Search Engine
Referral : Who or Where?			Email *
Please Check ALL functions you would like to consider the consultant to perform for your business:
	Do the work	Lead the work		Act as a mentor and advisor
	Transmit knowledge	Serve as facilitator		Be an independent observer
	Act as change agent	Manage projects		Serve as technical expert
	Implement Solutions	Provide Recommendations		Collaborate with management
Issues / Questions?