Appendix B
Appointment & Data Form

• Name of Individual to be interviewed:
__________________________________________________________________________

• Appointment Date__________ Time__________ Appointment Made By_________________

• Appointment Location 	___ Office (Company Name)______________________________
			___ Home
			___ Other_____________________________________________

• Address __________________________________________________________________
__________________________________________________________________________

• Phone Number At The Appointment Location ______________________________________

• Directions/Parking/Special Instructions___________________________________________
__________________________________________________________________________
__________________________________________________________________________

• General Information:
Describe the potential value of this individual to the Project and to the proposed campaign.
Indicate type and duration of any key business, civic, and community affiliations, relationships, etc.,
especially those with our organization:
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________


• Past or current personal or family financial support___________________________________
__________________________________________________________________________


• If and where the interviewee has control or influence with corporate, foundation, or governmental
funding sources______________________________________________________________
__________________________________________________________________________