Engagement Form ClientCompany/Organization: Company Address (U.S.) Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Website Brief Company Description:Point of Contacts (POCs)Name* First Last Title Email* Direct PhoneMobile PhoneInstructorPrimary Instructor PreferenceNo PreferenceJocko Willink-Co-Author, CEOLeif Babin-Co-Author, President and COODave Berke- Chief Officer of Development and CurriculumJP Dinnell- Chief Training OfficerCodey Gandy, InstructorCarlos Mendez, InstructorJason Gardner- InstructorSean Glass - InstructorAndrew Paul- InstructorMeg Miller- InstructorCordell Bennigson-InstructorJamie Cochran-InstructorSteve Ward-InstructorDanny Ziem- InstructorOther Instructor Preference Any other instructors of preference for your event.Engagement/Event DetailsEvent Type*WebinarStrategic AdvisingVirtual KeynoteKeynote (1.5-2 hours)Workshop - Half Day (3-4 hours)Workshop -Full Day (6-7 hours)Combined Keynote and Workshop -Full Day(6-7 hours)Field Training ExerciseDate MM slash DD slash YYYY Start Time Venue Address (U.S.) Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Estimated Number of Attendees Brief Event DescriptionBudgetBudget/Range TravelWhat is the nearest major airport to your event venue? What is the approximate driving time between this airport and the event venue? What time does the instructor(s) need to be on site at the event venue? What time will the instructor(s) be concluded and able to depart the event venue? Hotel Recommendations or Information
