Contact Information:

Name of hotel or other site where event will be held:___________________________________________

Complete Address: _______________________________________________________________________

Name of main event planner from your organization: ___________________________________________

Business Phone: ______________ Cell: _____________________ Email: ____________________________

Position and/or Role:______________________________________________________________________

On-site event coordinator: __________________________________ Phone: ________________________

On-site tech person: _______________________________________ Phone: ________________________

Logistics:

Event Date(s): _____________________ Event Title:___________________________________________

Date(s) Sharon or other PNDC trainer speaks: ________________________________________________

Sharon’s starting time(s):________________________________  Ending time: _____________________

Specific theme or purpose of the event: _____________________________________________________     

The person who will introduce Sharon: ______________________________________________________

Business Phone: _______________Cell: ________________Email: ________________________________

Position and/or Role:______________________________________________________________________

Link PNDC Websiteto On-Line Event Information : Would you like for us to arrange to link Sharon’s web site to your on-line information about your meeting? If so, please give contact:  

Name: ___________________________________________ Email: ________________________________

Phone: ___________________________Your Organization's Web Address: __________________________

Ordering Books and/or CDs for participants: If you'd like to discuss ordering books and/or CDs as part of the conference materials for participants, we can create package prcies for you. You can also purchase set(s) for your on-site library at one or more locations.

Yes_______ No______ Would like more informtion______

Having Books and CDs for Participants to Purchase: If you'd like to discuss having books and/or CDs on Powerful Non-Defensive Communication available for participants to purchase as support materials we can make them available. Sometimes an organization will purchase the book or single CD for participants and make other items optional for participants to purchase. This includes the book, Taking the War Out of Our Words, the book on CD, a single CD that is a thorough summary of the skills sets presented in the book, and the audio book, Taking Power Struggle Out of Parenting.

Yes_______ No______ Would like more informtion______

The Audience:

How Many People Will Attend The Conference? (Estimate):____________

What percentage of your organization does this represent, based on total number of employees or members (locally, nationally, and/or internationally): _____________

What positions/professions will be represented?: :_______________________________________________

_______________________________________________________________________________________

For example, a law conference might included attorneys, clerks, and judges, or just attorneys; a non-profit might include all staff and management; a corporation might include one department such as adminstrative staff or engineers, or it might include managers only, or employees only, or a mix.

If people will be attending from different departments in your organzation or different sites, what departments/units/teams/sites will be included and approximately what percentage of the people will be from each?:

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

How diverse will people be in terms of factors such as age, education, ethnicity, gender, andrac :

_______________________________________________________________________________________

_______________________________________________________________________________________

_______________________________________________________________________________________

The Institute for Powerful Non-Defensive Communication
Phone: 800-714-7334 or 510-655-8086 • Email: info@pndc.com
Powerful Non-Defensive Communication is a trademarked name. © 1994-2009 Sharon Strand Ellison