Request a Program

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COMPLETE THIS FORM IF YOU WOULD LIKE TO SCHEDULE A CORPORATE WELLNESS PROGRAM OR HAVE ANY QUESTIONS. WE WILL BE IN TOUCH SHORTLY.

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Name: *

Company/Organization: *

Address: *

E-mail address: *

Phone *

How did you hear about us? *

How many total employees does your company have? *

How many people do you estimate will attend the program? *

Have you had a laughter class/wellness program before? *

What type of program are you interested in? *

What would you like the participants to get out of the program? *

What day(s) and time(s) are available for the program? *

What is your budget for the program? *

What are some good days/times to contact you this or next week? *

Comments and/or questions

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