Jessica Latin Speaker Request Form

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Please fill out the following information. Your request will be followed up within 24-48 business hours.

Email *

Name of Organization hosting event *

Name of Event/Speaking Engagement *

Event Theme/Topic Requested *

What type of speaking engagement is this? *

Keynote

Panel

Workshop/Seminar

Location of Event *

Start Date of Speaking Engagement *

YYYY

Ending Date of Speaking Engagement *

YYYY

Time Speaking Engagement starts *

Time

Number of Attendees Planning to Attend *

Amount of time for speaking engagement *

30 minutes

45 minutes

1 hour

2 or more hours (workshop/seminar)

What is your organization's speaker budget? *

I understand and agree to the terms that for paid speaking events, Jessica Latin requires a 50% deposit to be paid upon booking via virtual payment format. The remaining 50% is due 24 hours prior to the event. *

Yes

Will transportation/lodging be provided by organization? *

Yes

Are you providing videography/photography services for your event? *

Yes

Are there opportunities for speakers to sell products or services at your event? *

Yes

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