Contact Form For Jeremy Brotha James Reisig
Please fill out this short intake form, and I will follow up with you as soon as possible.  

Thanks in advance for being thoughtful about your answers to the questions below.  

Much appreciated, 
Jeremy 
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Name *
Email *
Phone Number
What type of experience are you planning? *
Required
What are you interested in hiring me for? *

Tell me about the experience you are planning.

How many people?  Where is it? When is it?  Is it Online or In Person?

The more details you give me the better I will be prepared to respond.

 *
When you think about the meeting, training or event you are interested in hiring me for. 

What does success look like to you?  What have you accomplished?   What do you want to be celebrating when the meeting, training or event is over? 
Are you the primary decision maker, or are there other decision-makers involved?
Do you have a budget? If so, what is the range?
Anything else?
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