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Phil Gerdes'Pre-Event Intake Form

Please fill out all the necessary fields in order for Phil and the team to be able to prepare accordingly for your event. Thank you!

    * Required Fields
    YOUR EMAIL ADDRESS *

    Audience & Goals

    Who will be in the room (Check all that apply)? *
    Anticipated Attendee Count: *

    Event Positioning

    What’s the total allocated time Phil will be speaking? *
    How will Phil be positioned (Check all that apply)? *

    Impact Expectations

    What delivery style are you envisioning (Check all that apply)? *
    Interactive Elements Envisioned? *

    LOGISTICS

    EVENT LOCATION (CITY/STATE) * EVENT VENUE (FULL ADDRESS) * Main Event Dates: *
    Will there be pre-event/post-events? (Social Events, Dinners, etc.): *
    PRE-EVENT / POST-EVENT DATES: *
    Are you anticipating Phil shooting a promo video for this event?: *
    Phil’s team will secure flight, how will flight cost be handled?: *
    What Hotel Suite will be secured for Phil’s stay? *

    Connection Opportunities

    Will Phil have additional time with attendees before or after his session? *
    Are there opportunities to share Shift Immersive Coaching resources? *

    Confirmation & Contact Information

    Full Name: * Organization Name: * Event Title: *
    Best Email for Communication: * Best Phone Number for Communication: * Secondary Contact Person (Name, Phone, Email): *