Please update your flash or use a different browser.
 

Pre-Program Questionnaire
Please complete this form and the press the "Submit" button below. This form helps Jack better prepare for your program. If you prefer, a print version is available. If you would like to talk to someone immediately, you can call:  Jenelle Nadeau at 954-801-4597.

Contact Info:










If any problems or emergencies occur in route to the program, who should Jack contact:




Program Agenda:



Jacks Introducer:


Appropriate attire for program:



What takes place immediately before and after  Jack’s presentation (another speaker, break, etc.)?



Would you like information on Jack’s books, other products to reinforce the Impact of Jack’s presentation?

No


Key Contact List:
Which person can Jack interview over the telephone to further tailor the event to your needs?








Officers of the Company (or send a flowchart)








Please include with questionnaire if availiable

  • Logo
  • Annual Report
  • Information to help Jack understand your organization
  • Video about your organization
  • A rough or final agenda of the meeting

Program Contents:


























Audience Profile:


What three main things do you think we should know about your group before addressing them?






Are spouses invited
Yes No








What are the names and proper titles for the following individuals in your organization?





Background:


What are the two most important benefits you offer to your customers?