Welcome to JamieClarke.com!

First Name:
Last Name:
Company:
E-mail Address:
Date of Jamie's Presentation:
Time of Presentation:
Length of Presentation:
Presentation Venue:
Room Name:
Address:
City:
Province / State:
Postal / Zip Code:
On-Site Contact:
Their Emergency Phone #:
AV/Room Setup:
Events in room prior to presentation?:		Yes No
Duration of these events:
AV Supplier:		Company Phone#: Fax#: Contact Name:
Preferred time for AV check:		AM of Presentation Afternoon of Presentation Evening Before Presentation
Audience Size:
Preferred attire for Jamie:
Airport Transfers:		Jamie will be picked up Jamie to take cab Jamie will be returned to airport Jamie to take cab back to airport Car Service Co. Phone#:
Accommodations:
Address:
City:
Province / State:
Postal / Zip Code:
Telephone#:
Fax # for Guests:
Confirmation #:
Comments:

You can also print this form and fax to Azimuth Inc. Fax: (403) 230-2773