Breaking Average Leader Recommendation

Who do you know who is breaking average?

We are always on the hunt for game changers and leaders who are making a difference, who are breaking average!

We are willing to bet that you know someone making an impact like this; someone who is making a difference in your community and the world! If so, we encourage you to take a moment to fill out this short survey. We want you to identify someone you think the world should know about, and that we can possibly interview for the Breaking Average Podcast.

Your friends,

Paul and Mike

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* 1. LEADER RECOMMENDATION - The Leader You Are Identifying for the Podcast and to be recognized.

Leader's First Name *

Leader's Last Name *

Leader's Organization/Business

Leader's City/Town

Leader's State/Province

Leader's ZIP/Postal Code

Breaking Average Leader Recommendation

Who do you know who is breaking average?

Question Title

* 1. LEADER RECOMMENDATION - The Leader You Are Identifying for the Podcast and to be recognized.

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* 2. Leader's Email Address

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* 3. Leader's Phone Number (if known)

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* 4. Leader's Country of Residence