Dale's SPEAKING Application

Dale's Speaking Application

Please fill out the form and Dale will contact you soon.
Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
E-mail*
Phone Number*

Area CodePhone Number
Best Time to Call*

:HourMinutesAM/PM Option
Your Website Page
Your Facebook Page
Tell Me About Your Event. Audience Size, Theme, etc...
Location & Dates of Your Event
What type of Speaking or Training are you looking for:*

Afternoon Training for your TeamKeynote Speaker for your EventWhole Weekend Training for your Event
* Afternoon Training: Includes you providing Airfare, Hotel, & $1,500 Speaking Fee

* Keynote Speaker: Includes you providing Airfare, Hotel & $2,500 Speaking Fee

* Weekend Training: Includes you providing Airfare, Hotel & $5,000 Speaking Fee
WHAT specific Areas are you looking to Target?*

Mechanics, How to's, etc...Tools,Processes,Systems etc...Accountability,Motivation,LeadershipBuilding Teams, Rank Adv. etc...Lead Generation,Automation, etc...Branding,Funnels,Social Media,etc..
EXPLAIN other Target areas your team needs that is not listed above . . .
All the information submitted on this form is kept strictly confidential. Nothing you share with us is ever shared with anyone. This information is only used to help Dale McNelly understand your specific coaching needs. Once your submit your information it's sent off to Dale for review and he will be calling you within 24 to 48 hours.
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Dale's Speaking Application