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If you would like more information on how to hire us for an event, please fill out the form below and we will get back to you! Please remember that the more information you provide, the better we can assist you with your inquiry.

All information is kept confidential and is used strictly for our own purposes. We do not resell or disclose any information to third parties with out your explicit consent.

If you would prefer not to fill out the following form, feel free to contact us by email at: speakerjim@prodigy.net, by phone toll free at: 1-800-215-5528 or by Fax at: 518-448-5545.

*First Name:

*Last Name:

Organization:

Title:

Address:


City:

State:

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*Phone:


Fax:

*Email:

*Projected Date(s) of the event:

*Expected Attendance:

Comments and Questions:

* - denotes fields that are required. Please be assured that all information supplied will be kept in the strictest of confidence.