Pre-Program Questionnaire

Great information builds great programs. Help Patricia do the best job possible when speaking for your organization. Please answer the following questions on-line (just fill in your comments and click ‘Send’) or print this form, complete it and fax to Patricia Katz at Optimus Consulting (306) 242-0795.

Also, please forward a copy of the full conference or event program and any other information that would be helpful in preparing to work with this group (i.e.- annual reports, brochures, newsletters, etc.)

Contact Data








The Program







Your Organization




Audience Profile


Males Females





Name Job Title Phone Email
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Other

Any specific requests, cautions, advice that you would offer: