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ABOUT YOU AND YOUR NEEDS

*Last Name

*First Name

*Company Name

*How would you prefer to be contacted?

*Phone

*E-mail

What does your company do?

How can we help you?

What are the most important kinds of information that your people need to remember on a daily basis (ex. scripts, names, products or services)?

Check off the areas of memory that are important to you and what you would like to learn (check all that apply):

Increase your ability to remember and recall names and faces

Increase the long term memory retention of technical data

Be able to do speeches and presentations without notes, cue cards and brochures

Learn information faster and more efficiently thus reducing the learning curve

Recalling information quicker

Eliminating stress and increasing confidence

Studying techniques and eliminating anxiety in the classroom

Phone number must be included in this form. Thank you for helping us help you!

When do you usually conduct your meetings?

Weekly

Monthly

 Other

What day of the week?

What time are your meetings held?

AM

PM

How many people will be attending?

What are their job functions?

If you have any questions or comments, please e-mail us at: service@memory-mti.com

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Any additional information or questions that we should know?

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