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Submit your Testimonial Here

Thank you :-)

We greatly appreciate that you have agreed to write a short testimonial to support our ongoing marketing efforts in South and southern Africa.

For your convenience, we have created a simple form, below, for you to complete.

We certainly don't want to prescribe to you what to write. Please just say what you'd like to say, in your own way. (As jy liewer in Afrikaans wil skryf, doen asseblief net so!)

Over to you...

My Testimonial

Please note that all fields followed by an asterisk must be filled in.

This is my name, the way I would like it to appear
(e.g.: Joe Soap):*
This is my name, the way I would like it to appear
(e.g.: Joe Soap):*

This is my city, town or area as I would like it to appear
(e.g.: Simon's Town, W. Cape):*
This is my city, town or area as I would like it to appear
(e.g.: Simon's Town, W. Cape):*

At the time of writing I am:*
At the time of writing I am:*

	A trainee coach
	A certified coach

Here is the content of my testimonial
in no more than 150 words:*
Here is the content of my testimonial
in no more than 150 words:*

Permission to edit my content:*
Permission to edit my content:*

	You are free to make minor edits (spelling, grammar, etc.) without consulting me.
	You should seek my approval on any edits you may wish to make, no matter how minor.

Permission to use my testimonial:*
Permission to use my testimonial:*

	You may use my testimonial in any New Insights promotional or marketing material.
	You may use my testimonial in your marketing brochure and/or on your website only.
	See my comments below

My digital photo:*
My digital photo:*

	You already have a photo of me
	I will submit a photo separately soon
	I would prefer you not to use a photo with my testimonial

This is my contact email address (this is for New Insights use only and will not be published with the testimonial):*
This is my contact email address (this is for New Insights use only and will not be published with the testimonial):*

Additional comments/instructions (if applicable):

Please enter the word that you see below.