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Home
About Us
Services
Training Modules
Schedule a Training
Feedback
Contact Us
Journey Book
Speaker questionnaire
Please complete the questionnaire to help me create a custom experience for you and your team!
Name
*
First Name
Last Name
Email
*
What is the name of your business or organization?
*
What is the date and time of your event?
*
MM
DD
YYYY
Time
*
Hour
Minute
Second
AM
PM
What is the name of the event location?
*
What is the address of the event?
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Is there a theme for your event? If so, what is it?
*
Please share the agenda for the event if you have one. This helps me reinforce your message and the overall intent of the meeting.
*
Please share details about the audience to help me connect with them.
*
Is there sensitive subject matter that I should avoid that could be specific for the group?
*
Are there other speakers/trainers participating? If so, what topics will they cover?
*
How many people are you expecting at your event?
*
1-50
51-100
101-250
251-500
Over 500
How much time will I have to talk or present?
*
10-15 minutes
30 minutes
45-60 minutes
3 hour training
All day training
This is an ongoing training
How do you want the participants to feel after the talk or training?
*
Any other helpful information you would like to share?
Thank you!
