Intake form

Help us serve you better

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Email address *

What services are you interested in?

Please select at least one option.

Non-profit startup assistance

Grant writing and funding support

Advocacy for children and families

Leadership coaching

Career coaching

Life coaching

What is your current role?

How did you hear about us?

What is your preferred method of contact?

What is your organization's name (if applicable)?

What are your goals for seeking our services?

Which service or services are you interested in?

Please select at least one option.

Non-profit development

Grant writing consulting

Advocacy for families

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Empower & Advocate Consulting Services