Program Date

MM

DD

YYYY

Program Type *

Please indicate the type of service you received from Shari Fleming. Check all that apply.

Business Strategy Development

Business Coaching

Seminar Participant

Program Feedback

Please provide feedback about the substance of the program.

The program was very engaging.

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

I received meaningful information.

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

The program was valuable.

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

I was inspired by the program.

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

Venue

Please provide feedback about the venue.

The venue was convenient.

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

The venue was comfortable.

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

The venue was clean.

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

Presenter

Please provide feedback about the presenter.

The presenter was knowledgeable.

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

The presenter was clear.

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

I would recommend this presenter for future programs.

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

I give permission to Shari Fleming and her representatives to share the benefit I received from accessing her services. I understand that the testimonial may be shared on Shari Fleming’s website and social media pages (e.g. Facebook), and that my comments can be anonymous, if I wish.

I Agree.

Name

First Name

Last Name

Phone

(###)

###

####