Request form for Shemekka Ebony

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Thank you for connecting with me for , training, speaking, facilitating or partner opportunities. Please take a moment to fill out this contact form for follow up. We really respect your time and have made this part brief to help my team promptly prioritize and respond. I'm excited about the possibility of partnering with you and your work while illuminating your brilliant vision. Thank you for your time! I look forward to connecting with you shortly. Be Safe & Take Care.- Shemekka Ebony

Email *

Name *

Business (Organization) Affiliation

Date of Event/Program *

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Hard Deadline Date for confirmation *

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Speaker Request *

Virtual Presenter

Virtual Keynote

Conference Presenter

Workshop presenter/facilitator (in person)

Coaching (group/individual)

Other:

Organization/Industry Workshop Small Group Request. Please mark all sessions your organization would be interested in participating/hosting. We will follow up *

Best Practices in Community Engagement

Co-designing CPR (Community Pandemic Response) Policy Workshop

Leading with Equity: 6 week Accountability and Action Small Group

I Am Brilliant:You Are Too: Leading Together and Leading From Within Conference Session

Chasing 'ACES' Course: Leadership Development

Other:

Event Budget (Honorarium) *

Is travel & lodging included?

Follow Up Contact Person (Name, Email, and/or phone) *

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