Mindful Events | Event Speaker Request Form
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Welcome!

Welcome and thank you for considering our network of esteemed leaders for your event, seminar, or training session. This form is designed to gather essential information about your company, its goals, and the specific needs for your event. Your detailed responses will enable us to select the most appropriate speaker to align with your objectives and audience.

Here’s how the process will unfold:

  1. Initial Contact: After completing this form, the 'Contact Person' listed below will be our main point of contact.
  2. Review Call: We typically schedule a phone call with the Contact Person to review the submitted information and discuss any additional details or clarifications.
  3. Preliminary Proposal: Based on our discussion, we will send you a Preliminary Proposal outlining our suggested approach and speaker.
  4. Finalization: Once the Proposal is agreed upon, we will send a detailed Schedule along with the Terms of Agreement for your event.

Please complete all sections of this form to the best of your ability. If you have any questions or require assistance, feel free to reach out to us by email at Events@mindfulevents.com.

We look forward to working with you and creating an impactful experience for your audience.

Organization Details:
Name of Organization *
Contact Person *
Email Address of Contact Person *
Phone Number to Reach Contact Person *
Event Information:
Event Title (if applicable -- if you don't know yet, write "Schedule a Discovery Session") *
Event Date *
MM
/
DD
/
YYYY
Event Location  *
Desired Topic(s) for the Event: 

Please describe the main topic(s) you would like the speaker to cover.

 *
Event Duration 

Please specify the length of time you would like the speaker to engage with your community (e.g., 30 min Keynote, 2 Hour Workshop, 1 weekly Training for 1 month, 2 months, etc..) 
 *
Audience and Attendance: 
Target Audience for the Event: 

Please describe the audience who will be attending (Industry professionals, entrepreneurs, sales representatives, students/athletes etc..) 
 *
Expected Number of Attendees: *
Event Primary Objectives 

What are the main goals you hope to achieve with this Event? 

(e.g. educating attendees, providing mindfulness techniques, meditation session, breath-work training, goals setting, team building, sales training, etc..)
 *
Are there any known challenges?

Please list or describe any known challenges that your audience is facing that you want to address in this event.
 *
Additional Information: 

Special Requests or Requirements: 

Please put any additional information or specific requirements you have for this event. 

Please feel free to use this space for any questions that you have that you would like to discuss on our 'Brain Storm Session'
 *
Submitters Confirmation
Please put your Name and Today's date below.  *
Thank you for taking the time to connect with us. 

We look forward to co-creating an event that truly inspires and reaches your community in ways that it has not before. 

In Partnership, 

Mindful Events Team
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