JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Training and Speaking Request Form
Please fill out and submit this form. Emmanuel will contact you soon.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Name
*
Your answer
Organization and/or Event name
Your answer
Event Type
*
Training/Workshop
Keynote
Panel Discussion
Other:
Event Style
*
Virtual
In-person
Required
Ideal Start Date
MM
/
DD
/
YYYY
Ideal Start Time
Time
:
AM
PM
How long do you expect the Training/Workshop will be?
Under 1 hour
1 - 2 hours
2 - 2.5 hours
3 - 4 hours (Half day)
5 - 8 hours (Full day)
Other:
Clear selection
What Topic(s) would you like Emmanuel to address?
*
Your answer
Target audience and estimated number of attendees
Your answer
What is your budget for Training/Keynote?
*
Your answer
If the in-person event is outside the Portland-Metro Area, is travel/lodging/ground transportation included for? Will meals be provided?
Your answer
Phone number
Your answer
Additional Comments
Your answer
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
Forms
