e-mail address:
Please enter your type of group: Corporation Association Business Government Agency Health Institution Educational Institution Non-profit Service Club Other (please specify in blank below)
If you wish Jim to lead a seminar, please check the length: 20-30 minutes 30-60 minutes 1 1/2 hours 2 hours 3 hours 4 hours 5 hours Other (please specify in blank below)
TOTAL length of time you will have Jim speak at your engagement:
Please take one last look at this Program Request Form to make sure that you have given Jim all the information Jim needs to contact you, then check here to confirm your request is: complete
Thank you for the opportunity to soon be discussing your program.
Jim's brochure, audio and video demo tape are available upon request. To submit this form please:
This program is supported by most major browsers. But, if you haven't received a confirmation e-mail back from Jim within two days, then please bug Jim by e-mail at: jim@jimrichardson.com or phone Jim at: 415-877-4424. After pausing long enough for the form to go through, you can clear the form by pressing:
You can also print this form, check to make sure that all blanks printed out, and then mail it to Jim at:
Copyright © 1997-2019