SkillsTrac Referral Lead Form

Referral Lead Form

	Fields marked with * are required
	Referral fee expectation in Rand or %: *
	Referral Partner Details
	Contact Name: *
	Address:
	City:
	Province:
	Zip/Postal:
	Phone Number: *
	Fax Number:
	Email Address: *
	Web URL: *

	Are you a Service Provider / Consultant for Human Resources and/or Organizational Development?


	Referred Company Information (Lead)
	Referred Company Name: *
	Contact Name: *
	Address:
	City:
	Province:
	Zip/Postal Code:
	Phone Number: *
	Fax Number:
	Email Address: *

	Please describe your relationship to the lead:

	Number of employees:

	Other Software they are considering:

	Timeframe for implementation of SkillsTrac:

	Budget for SkillsTrac:

	What are they looking for in a new system?

	Are you capable/interested to provide any of the following additional services for the potential client at a market related fee?
	Consultation activities around Key Result Areas, Performance Indicators, Competence frameworks Strategic Planning Data Capturing Building Scorecards
	Other Comments: