Request a Speaker
Experiencing Challenges Submitting Your Speakers Request?

Please let us know by emailing the queenzwithbrands@gmail.com mailbox. We apologize for any inconvenience and thank you for your help.

Requesting a speaker is very easy:
  • Please review the Privacy Policy to understand how we use the information gathered to complete requests. If you have any questions or concerns, please contact us. 
  • Simply complete the online speaker request form below. A Queenz representative will review your request and contact you.
  • We appreciate you making every effort to submit this form at least 30 days before your event (and a maximum of 6 months prior to your event). Requests of extremely short notice (within 15 days of the event) may not be processed since it will not allow for adequate staffing coordination.
  • If a response to your request for a speaker is not received within 15 days of your original request date, please contact us. Please note that a submission does not guarantee a speaker; however, we will do our absolute best. 
  • If you want Queenz to participate in your career day, health fair, or facilitate a demonstration at your community, organization, or school event, please fill out this Community Relations form instead.
Sign in to Google to save your progress. Learn more
Email *
Event Overview
Event Title
Name of Organization Hosting Event
Event Location:
Event Date 

must be at least 30 days out, and a maximum of 6 months prior to your event.
MM
/
DD
/
YYYY
Event Start Time
Time
:
Event End Time
Time
:
Please List Time Zone
Travel Expenses Covered

Please note: Queenz does not cover travel expenses for requested speakers.

 *
Expected Media Coverage: (optional)
Clear selection
What is the purpose of this event?
 *
Will virtual availability be an option for this event?
 *
Contact Person
Contact Name
 *
Organization Name and Location:
 *
Office Number:
 *
Cell Number:
 *
Email
 *
Please give a brief description of your organization:
 *
Presentation Details
Topic of Presentation
 *
Type of Presentation:
 *
Length of Requested Presentation
 *
Audience and Key Participants
 *
Required
Audience Size
 *
Required
Audiovisual Capabilities
Audiovisual Capabilities?
 *
Additional Instructions
 *
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
Google Forms