are interested in finding out
        more about what "cross -
        culturalism" actually means

believe that you and your
        colleagues have a need which
        requires a solution

would like us to meet you in
        order to help you with your
        request

require a concrete assignment

Please tick the option you are interestesd in:

Cross-cultural awareness
      seminar

Team workshop

Preparation for a new
      overseas assignment

Workshop on improved
      cross-cultural collabarotion

Individual coaching for ...

Other issues you are interested in (please provide a brief description, thank you!)

Which countries are you particularly interested in ?:

France Italy

Switzerland Germany

... other, please specify:

Which target groups in your company prompted you to make your request ?

Please describe the group in question:

Mono-cultural
Bi-cultural
Multi-cultural

What is your reason for proposing a cross-cultural measure ?

Which objectives should be achieved by the measure ?

Please provide any information you feel may be important for me to know you better:

Last but not least:
What would you like me to do now?

Call me

on  / / ,
        (DD / MM / YYYY)

Time  .

Send you a proposal
By e-mail
By post..

Meet so that I can examine your request for a cross-cultural assignment in your company in more detail. Please proposal a time and date:

Date  / / ,
                 (DD / MM / YYYY)

Time  .

Would you like to receive confirmation by e-mail ?

YES !

Surname

First name

Company / Organisation

The Internetaddress of your Organisation, http:// . . .

Address, Street

Post'Zip code / City

Country

Direct fax

Direct telephone

E-mail