Connecticut Business Network Summary

Jeffrey Cohen - jeff@imagesites.com CALL (860) 647-7725
Welcome! Our Relationship Building Sessions are different in that we focus on who you are, not who you know. We stress the intimacy of a relationship. Once that is established, doors of opportunity open. Towards that end, we need to know a little bit about you. Please complete the questionnaire below. It will help us help you to make some instant connections and begin building meaningful relationships. Sending back the questionnaire automatically registers you for our next event.
How did you hear of us?
Who are you?
Name:
Company:
Type of Business:
Preferred contact method:
Phone:
E-Mail:
Other:
Tell us about yourself:
Town where you live:
Family members (Names and Ages):
Your latest passion, outside of work:
Favorite musical artist or genre:
Last book you read:
Last trip you took:
Top two things on your "things to do before I die" list:
One fear of yours you are willing to share:

Please make sure all information is correct before submitting.

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