Information Request Center Please complete form to submit your information request YOUR CONTACT INFORMATION * First Name Last Name Email * Phone (###) ### #### Mailing Address (Optional) Address 1 Address 2 City State/Province Zip/Postal Code Country YOUR POSITION * Please select the option that best describes you: HR Director/CHRO (or Agency Equivalent) HR Deputy/Assistant Director HR Manager (with direct reports) HR Manager (no direct reports) HR Specialist (primarily responsible for 1-2 HR functional areas, i.e. Benefits & Comp) HR Team (primarily providing departmental administrative support) HR Intern HR Volunteer HR Student Considering a Career in HR HR Consultant or Coach (working directly with local government clients) Agency Manager/Administrator or Deputy/Assistant Agency Department Head Unemployed Self-employed Nothing Captures the Essence of Me! (Please indicate your position or circumstances in the Comments box below.) Comments: AGENCY INFORMATION * Please provide the name of the agency for which you currently work in the box below. If unemployed or self-employed, please type "NA." Agency Website http:// INFORMATION REQUESTED * Please check all options that apply: Coaching Consulting Connecting (Keiva Jade™ .COSMOS) Other (Please provide details in the Comments box below.) Comments: Message * Please add any other information that will help us to thoroughly respond to your request. Your Request for Information from KEIVA JADE™ has been successfully submitted.Your request will be reviewed, and you will be contacted within 48 hours.If your request requires priority attention, please call (844) 777-2529.Thank you for looking to Keiva Jade™ as Your HR Partner .INside GOVERNMENT.Wishing you beautiful days until we connect again!-Keiva Jade