BOOKING MONICA
 
In order to ensure that your needs are met please fill out the simple on-line form below
or   Download the Form and fax it to (306) 242-9109 or mail to the address above.
 
 
(1) Contact Information

Organization: 
Contact Name: 
Phone: 
Fax: 
E-mail: 
 
 
(2) Event or Project Details

a. Requested Date or Approximate Timeframe:
 
b. Please indicate which service(s) you are interested in:
   Keynote Presentation
   Workshop
   Customized Consulting for Your Organization/Community
   Shared Visions Program for Youth
   Personal Coaching
   Teambuilding Session
   Intrapreneurial Development & Training

 
c. Briefly describe the purpose of the event or project goals:
 
d. Where will it be held?
    i.e. community and province or state
 
e. What are you specific objectives for Monica’s presentation or services?
    eg: to motivate, inspire change, goal setting, team building
 
f. What is the number of potential attendees or participants?
 
g. What will the approximate gender percentage be?
  Male     Female     
h. What will the Average age or age range be?
 
i. Briefly indicate any challenges or successes your organization and/or audience may    be facing that will be relevant to Monica’s provision of services:
 
j. List any other individuals that Monica could speak to prepare for her work with you?
   e.g. John Doe, Manager, (555) 555-5555, johndoe@johndoe.com
 
 



 
 
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