P. JASON KING ASSOCIATES, INC. A Retained Executive Search, Career Development, and Consulting Organization To Receive Our Free Proposal YOU MUST have Interest in one of our Consulting Services ALL QUESTIONS MUST BE ANSWERED Today’s Date: How Did You Hear of Our Service? 1. Your Full Name 2. Title or Function 3. Company (if applicable) 4. Address 5. City State Zip Code Country 6. Personal E-mail 7. Business E-mail 8. Daytime or Work Phone (include Area/Country code) Best time to reach (include time zone) 9. Evening or Home Phone (include Area/Country code) Best time to reach (include time zone) 10. Fax Number (include Area/Country code) 11. Pager Number (include Area/Country code) 12. Cell Phone (include Area/Country code) Best time to reach (include time zone) 13. Proposed Assignment 14. Anticipated Budget $ 15. Anticipated Timetable for Start of Project 16. How long have you been waiting to start? 17. Do you have a Formal RFP? We will e-mail you to confirm receipt of your form. Thank you for giving us the opportunity to serve you. When you have completed the form, please e-mail to: ConsultingRFP@PJasonKingAssociates.com (In SUBJECT BOX place words CONSULTING). If you have any questions, Contact us 1-212-697-7899 Monday – Thursday, 9:00am to 6:00pm, ET or e-mail us at RFPQuestions@PJasonKingAssociates.com (In SUBJECT BOX place word QUESTION).  © Copyright P. Jason King Associates, Inc. 08/03  © Copyright P. Jason King Associates, Inc. 02/06 All Rights Reserved