This itty bitty questionaire will help us to help you.

Although we would love to gather more info like "What's your sign?" and "What's your favorite holiday destination",the following would suffice to help us get started with the crafting of the initial proposal.

 * Compulsory Fields
Contact Information *
Your Name:  
Company: 
Address: 
Phone: 
Fax: 
Email Address: 
What does your company do? 
Program Information *
What division/dept. the participants from? 
What type of event are you planning? 
Is there a theme? 
What are the desired outcomes/ learning that you would want our facilitator to debrief and transfer back to personal/ organization? 
Any other concerns / special needs about the program? 
How much time is allocated for the program?  Day(s)  Hour(s)
Participants Information *
Gender: % Male   % Female
Age Range:  Between  and 
Num of Pax:  
Do you have a venue or program date in mind?
Venue:  
Date 1:  /  /  (Format: DD/MM/YYYY)
Date 2:  /  /  (Format: DD/MM/YYYY)
Has this group participated in any similar activities in the past?
What?  
When?  
Where?  
What worked, what didn't?  
What were the goals?  
How did you hear about us?
Internet - Which Search Engine?  
Referral:  
Others:  

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