Standard Seminar Request Form

Please fill in the following information and send it to us via Internet to request a standard seminar.

You may also Fax or mail it to us. Click here to download this form in RTF format. Fill out the form and Fax it to 860-691-0358 or mail it to Impact-e English Training / 169 Upper Pattagansett Road / East Lyme, CT 06333.

Contact Person & Group Information
Contact Person's First Name :
Contact Person's Second Name:
Address:
Address (line 2):
City:
State:
Zip:
Country:
Name of Company:
Position / Title:
Email Address:
Telephone Number:
Fax Number:
How did you hear about us?
Training dates - first choice:
Training dates - second choice:
Training Location:

Group Details

Please tell us about the participants. (E.g. How many people. What departments they're from. Their positions in the company. Their English background. Etc.)
Seminars

Intensive Business English

Presentations / Public Speaking

English Orientation / Living in the USA

Negotiations

Enter your email address (required for "Send" action):