Book Me

Thank you for taking the time to fill out this questionnaire. Feel free to email me at [email protected]

Meeting Organizer?
Phone:
Email:
Company Name:
Website:
Date or Dates of event or events for speaking requesting Roger to speak:*
Date Format: MM slash DD slash YYYY
Date Format: MM slash DD slash YYYY
Will it be a keynote speech?
- Yes
- No
What is the theme of your event?
Tell me more about what you would like to accomplish through this speaking event, presentation or facilitating an executive group?
How many people will attend?
Do you have a budget for this event?
Who will be in the audience? What is the overall demographic?
Would you like to include copies of "Staying Happy, Being Productive" or "Expedition" for each of your participants?
- Yes
- No
What are the main 3 things you would like to accomplish through your event this year?

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