Consultant/Trainer Name:

Name of business (if different):

Mailing Address:

City:

State/Province:

Zip/Postal Code:

Country:

Phone:

Fax:

Email:

Web site:

Do you want the directory to link to your email?  Yes  No

To your website?  Yes  No

Is your web site already linked to AVA�s?  Yes  No

If not, will you link your web site to the Directory?  Yes  No

Are you limited geographically?  Yes  No

If yes, what is your service area?

Clients/References
Please list three clients to be listed in the directory. Please include the following information for each client:

Name / Organization /  Email   

Client One � Contact Information

Client Two � Contact Information

Client Three � Contact Information

Graphics
Your Directory listing may include one logo and one photo. 
Do you want to include a logo:    Yes  No
Do you want to include a photo:  Yes  No

If you want to include graphics, email jpg or bmp files to the AVA office.
Or �snail� mail to AVA Directory of Consultants and Trainers
P.O. Box 32092, Richmond, Virginia, 23294, USA

Consultant and Trainer Narrative
Provide a brief description of your services and credentials. This needs to be a maximum of 100 words. Do not include the information you listed above. Be sure to include the appropriate key words. See below.

The web page will provide the following suggestions for key word searches, so choose your words carefully.  Each listing will accommodate up to 25 key word searches.

Board governance Books Collaborations Consultant Corporate program Employee  Evaluation Facilitation Faith Fund raising Gifts Government

Humor Interactive trainer Key note Leadership Marketing Media relations  Mentoring Motivation Networking Newsletter Nonprofit  Organizational development

Presenter Public relations Publications Recognition Risk Software Strategic planning Volunteer centers Volunteer referrals Youth

What Comes Next?

• The AVA staff and web master will format and post your listing.
• Review your listing for accuracy.
• Keep your on-line listing up to date. E-mail changes as needed to [email protected].
• Report when you get referrals from the directory.

Payment Schedule
Members of AVA are so designated in the Directory and receive a discount on the listing fee. 
Are you currently a member of AVA?   Yes  No
For more information on joining AVA check the membership web page. Basic membership is currently $50.

 I have decided to join AVA. I am including my membership form and dues to AVA now and checking the member column on the payment chart below.

Fees	AVA Members	Non-AVA Members
Basic Directory Listing	$50 US	$75 US
AVA Membership Dues		$50 US
Total Amount Enclosed:	$	$