Development Office Cooperative Extension service 2301 South University Avenue, Little Rock, AR 72204; 501-671-2264
Request for Prospect Research (Extension related research only)
Prospect Name
Address
City	State	Zip
Phone	E-mail Address
Website
Date of request	Date Needed
Current Relationship with Prospect
Cultivation Plan with Prospect
Approval:	Priority:	A B C
Please use additional sheets for more detailed information. (List the name of prospect’s business; position title; family relationships; hobbies and interests; ties to Extension; local or regional, professional and community affiliations, contact people, and past major gifts.)
Submitted by:	Date