To help Jack prepare a program that is focused on your unique needs, please complete the following:
Your Name
Organization
Phone Number
Address
Fax Number
Email Address
City/State/Zip
What type of program TEAM BUILDING program are you interested in booking? Half-day Seminar Full-day Seminar Multi-day seminar Keynote After-dinner presentation Mystery Seminar Consulting engagement Other PLEASE SELECT ONE
Type of Event Annual Meeting Awards Dinner Regional Meeting Special Event Training Program Other PLEASE SELECT ONE
Location
Other Event (describe below)
Event Date January February March April May June July August September October November December 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 2008 2009 2010 2011
What is the purpose of the event?
Briefly describe the attendees.
How will the attendees be dressed?
Formal Business Business Casual Casual
What are the team building "burning issues" of the attendees?
What types of personality profiles has your organization used in the past? (indicate all that apply)
DISC Myers-Briggs Wilson Learning Relationship Selling
Other
Describe your experience with profiling your staff members?
What happens right before I speak?
What will be done to follow-up the presentation?
How will this program complement the other things that are taking place in your organization?
What behaviors do you want to change or enhance?
What are three main points you would like to include in the presentation?
What else should Jack know that will help him better prepare his material?
Who are additional individuals that can be contacted to obtain valuable information?
Name Email
Press "Submit" to send this information to Jack!
