Pre-Program Questionnaire

It is important that Dan receive as much information as possible prior to your event to aid his customization of your program. Please complete this form and submit it as soon as possible.

How did we get here?

 Heard Dan speak before Word of mouth Speakers Bureau Website Social Media Dan’s book, Off Balance On Purpose Referral from another speaker

 Demonstrated Expertise Bureau Recommendation Video Preview Previewed Dan at another event Hired Dan in the past Other

Contact prior to meeting:

On-site contact:

The Event

 Single day Multi-day event

Logistical Information

The Audience

Organization's Background

 Annual Meeting Annual Conference Customer Meeting Strategic Planning Education Conference/Meeting New Direction Convention Other

Dan's Program