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Khalia Braswell Speaker Engagement Form
Thank you for your inquiry in having Khalia speak at your event. Fill out the following form and someone will follow up with you in 48 hours.
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* Indicates required question
Contact Person Name
*
Your answer
Contact Person Phone Number
*
Your answer
Contact Person E-mail Address
*
Your answer
Organization
*
Your answer
Organization Website
*
Your answer
Event Name
*
Your answer
Event Description
*
Your answer
Event Date
*
MM
/
DD
/
YYYY
Event Start Time
*
Time
:
AM
PM
Expected Talk Length
*
Will I be speaking for 15mins, 30 mins, an hour?
10 minutes
15 minutes
20 minutes
30 minutes
45 minutes
1 hour
Other:
Event Venue Location
*
Please include city and state if this is outside of Philadelphia, PA.
Your answer
If you are outside of Philadelphia, will your organization cover travel and lodging expenses?
Yes
No
Maybe
Clear selection
Speaker Budget
*
Your answer
What type of talk?
*
Keynote
Panel
Workshop/Training
Will the event be professionally recorded?
*
Yes
No
Maybe
Will the event be professionally photographed?
*
Yes
No
Maybe
Additional Details
Your answer
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