Request Information

In order to provide you with the information you need, we would like to know a little bit about your meeting.  If you are contacting us by email or telephone, please provide answers to the following questions.  Items marked with an asterisk (*) must be provided in order for the form to be processed.

Do you have a specific date in mind for a presentation?  If so, please provide the date and requested time so that we can check availability on Dan’s calander.
Name:*
Email:*
Title:*
Company:*
Address:*
City, State ZIP:*
Telephone:*
Event Date & Time:
Where is the event taking place?
What is the purpose of the event?
How many people will be attending?
How did you hear about us?
How else may we be of service at this time?

We look forward to working with you to help make your event a huge success!

Contact Dan to create a program customized for your organization. Email Dan or call 770.982.2664.

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