JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Invite Moorissa to speak
K
een to have Moorissa speak at your event? You're in the right place!
Please
submit the following speaking request form and we will let you know if it’s a good fit. T
hanks again for stopping by and we'll get back to you shortly <3
Sign in to Google
to save your progress.
Learn more
Your name
Your answer
Event name
Your answer
Affiliated Institution
Your answer
City
Your answer
Country
Your answer
The event is
Public (open to everyone)
Restricted (only by invitation)
Other:
Clear selection
Speaking engagement type
Keynote
Tech talk
Workshop / class
Interview panel
Discussion / fireside chat / Q&A
Podcast / livestream / video
Other:
Clear selection
Event will be recorded
TRUE
FALSE
Clear selection
Expected number of seats filled in Moorissa's session
Your answer
Expected number of CxOs / VPs in Moorissa's session
Your answer
Total number of attendees at the event
Your answer
Audience breakdown (% leadership, % developers, etc.)Total number of attendees at the event
Your answer
Is the date already set?
Yes, the date is set in stone
Yes, but we could move it
No, it's still flexible
Clear selection
Earliest date you'd like Moorissa to speak
MM
/
DD
/
YYYY
Latest date you'd like Moorissa to speak (leave blank if same as above)
MM
/
DD
/
YYYY
Minimum speech length (in mins)
Your answer
Maximum speech length (in mins)
Your answer
How many other speakers at the event? Please include some names if applicable.
Your answer
Which of the following best describes Moorissa's session?
Opening session
Middle session
Closing session
Main event
Other:
Clear selection
Topic keyword(s) you'd like Moorissa to speak about
Your answer
Link to event (if applicable)
Your answer
What are you offering in terms of speaker fees (card fee)?
Your answer
How did you initially find this form?
Moorissa's personal website (
moorissa.ai
)
LinkedIn
Through exploring Moorissa's blog (
medium.com
)
Through exploring Moorissa's social media (instagram / tiktok / etc)
Word of mouth
Emails
Other:
Clear selection
Which email would you like to be contacted at?
Your answer
[Virtual events only] Technical and practical details for the virtual event
Your answer
[In-person events only] Will the event provide a travel and accommodation for Moorissa?
Your answer
Thanks so much for filling out the form. Anything else we should know?
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
