Please complete our Request for Services form.
Web Address
1. How did the client learn about CESO?
Personal contactBusiness contactMediaOther (describe):
2. Describe ownership of the business: Year established: BandIndividualOn ReservePrivatePartnershipOff Reserve
3. Has client ever received CESO assistance?Yes No
4. How many employees does the organization have? Male Female
5. Employees under 30 years of age Male Female
6. Yearly sales over the last three years (if applicable)
Less than $20,000$20,000 to 49,999$50,000 to 99,999$100,000 to 249,999$250,000 to 999,999Over $1,000,000
7. Size indicators:
If a service company, how many customers/clients are there?
If an association, how many members are there?
Please identify other size indicators:
8. From the following list, indicate your type of business or organization:
AgricultureBand Government ServicesBusiness ServicesCommunicationsEducational ServicesFinancial ServicesHealth ServicesHospitalityManufacturingResource DevelopmentSocial ServicesTourismOther – describe:
9. What prompted the request for assistance? Please be specific.
10. What does the client want the Volunteer Adviser to do?
11. Identify the results expected from the assistance provided by the Volunteer Adviser.
12. Has the project received approval from chief and council, board of governors, or others?
Yes No Please explain:
13. Are funds available for the project/venture?
14. Please indicate one of the following that pertains to you:
First NationInuitMétisOther
15. Please indicate which band you are affiliated with:
16. Please indicate which tribal council you are affiliated with:
This form was completed by:
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