Form for Consulting Request

After you have filled it out, I will contact you to go over the details, answer any questions that you have, and then prepare a proposal for your review.

Name *

First Name

Last Name

Email *

Phone *

Country

(###)

###

####

Website

http://

Please describe your consulting request below *

Why do you want to work with me? *

What consulting services are you looking for? *

Please check the website for a description of services: https://www.riverstone.consulting/consulting

Are you looking for me to research?

Are you looking for me to design?

Are you looking for me to evaluate?

Are you looking for me to facilitate?

Is there something else?

What is the outcome you are looking for in this consulting? *

Please check off all that apply.

Written Research

Written Feedback

Written Observation

Written Report

Written Plan

Facilitated Meetings focused on Delivery of Content

Facilitated Meetings focused on Conversation

Facilitated Meetings focused on Idea Generation

Facilitated Meetings focused on Collaboration

Facilitated Meetings focused on Evaluation

Other

Based on the above, can you describe in more detail the outcomes that you checked off? *

What is the timeline for the consulting? *

Eg. when would you like to discuss your consulting request, when would you like a proposal by, and when would you like the consulting to happen?

Have you decided on a budget amount you are working with for the consultation? *

You don't need to tell me the budget amount, only that you do or do not have a budget amount decided.

Yes

Not yet

Will you be applying for a grant to cover the costs of this consulting service? If yes, when will you be applying for the grant? *

Do you have any questions or comments for me?

Thank you very much for filling out this consulting form. If you do not hear from me within the next week, please contact me at geraldine@riverstone.consulting

First Name

Last Name

Email Address

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-Geraldine Ysselstein

RIVERSTONE

Riverstone is a creating, facilitating, and consulting company that connects awareness, knowledge, reflection, and action. Through the integration of care and creative practices, I invite curious conversations about our humanity. Arts, culture, language, and story inform my work to move with humility towards systems change and social justice.

I acknowledge that I am a Treaty person and that I live and work in Treaty 7 which is the traditional territories of the Niitsitapi from the Blackfoot Confederacy, including the Siksika, Piikani, and Kainai Nations; Îyârhe Nakoda of the Chiniki, Bearspaw, and Wesley Nations; as well as the Dene of the Tsuut’ina Nations. I also acknowledge that this territory is home to the Otipemisiwak Métis Government of the Métis Nation within Alberta District 6.