Name
*
First Name
Last Name
Your Role
*
Email
*
Best Contact Number
*
Country
(###)
###
####
Organization / Company Name
*
Start Date for Work / Event
MM
DD
YYYY
What is the preference for delivery of the Service by Great Dane 921?
In-Person
Virtually
Combination of both
We are open to input
Additional Details Here. Ex: What Work Did We Do Together Previously? Who Referred You?
What would you like to cultivate and develop?
*
Organization Development
Empathetic Leadership
Cultural Intelligence
Restorative Retreats
Invite Dannie to Speak at your next event
Other
If you chose Other for the service you're inquiring about please provide more information:
What is the main challenge you are facing right now that you need support with?
*
What is the monetary commitment you can make to Great Dane 921 for this service?*
*
$3,500 or less
$4,000 - $6,000
$6,000 - $8,000
$8,000 - $12,000
$12,000 - $15,000
I cannot make a monetary commitment
Are You A Decision Maker?
*
When are you looking to make a decision by?
*
Immediately
In the next 2 weeks
1 - 2 months
3 months or more
I don't have a timeline in place
Is there anything else you'd like to share before a call?
