Success Story & Testimonial Request Form

Thank you for taking time to share your feedback! As an executive coach and keynote speaker, recommendations are a huge credibility builder and I deeply value your support. 

How would you rate your experience working with Janice Otremba?

Would you be willing to provide a video testimonial or participate in a case study interview?
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I understand my testimony may be used in connection with publicizing and promoting Janice Otremba Coaching & Consulting. I authorize Janice Otremba Coaching & Consulting to use my name, photograph (if provided),  title (if provided), and testimonial. 

I understand that this information may be used in various mediums for such purposes as publicity, illustration, advertising, and website content. I authorize Janice Otremba Coaching & Consulting to copyright, use, and publish these materials in both print and electronic formats. 

In addition, I waive any rights to inspect or approve the finished product wherin my likeness or testimony appears. I agree that I will make no monetary or other claim against Janice Otremba Coaching & Consulting for the use of my name, photograph (if provided), title, and testimonial.