Pre-Event Questionnaire
Please complete this pre-event questionnaire. The RNC team looks forward to reviewing your full request. Should you have additional questions, please contact info@drlaci.com or 414.909.1090

Thank you!
Email *
Organization/Association (please provide an informational overview.) *
Organization/Event Website *
Contact's Name & Title *
What is Your Role with Regard to Planning the Event? *
Contact's Address/City/ State/Zip *
Contact's Email *
Contact's Phone *
Event Location (City/ State/ Venue) *
What is the Date of the Event? *
MM
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DD
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YYYY
What Time Would Dr. Laci Speak? *
Time
:
What is the Purpose of the Meeting/Event? *
Describe the Demographic and Profile of the Group to be Addressed. *
What is Your Proposed Budget? *
Dr. Laci travels from Milwaukee, WI. Is Travel/Lodging Included for the Speaker, PLUS One Assistant? What is the Closest Airport? Will Ground Transportation and Meals be Provided? *
Would You Like Dr. Laci to Complete a Book Signing at this Event? How Many People Will Attend? Are You Interested in Pre-Ordering Books? *
Which Services are Requested for Dr. Laci to Provide? *
Required
What Topic Would You Like Dr. Laci to Address? *
Is There More Than One Appearance Requested? *
The Presentation is Slated for? *
Additional Comments *
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