Organization or Company Name (Include a link if available) *
Your answer
Title and Short Description of the Event *
Your answer
What date is the event? *
MM
/
DD
/
YYYY
What time am I requested to speak? Please note, I am employed full time M-F, so evenings and weekends are best. *
Time
:
AM
PM
How long would you like for me to speak? *
Required
Is this event virtual? *
Required
According to your response above, please either provide the full address of the event or the online platform for the event (Zoom, IG Live, etc.) *
Your answer
Is this a panel discussion or a solo speaking engagement? *
What topic would you like me to speak on? *Please note, if your event does not align with one of these topics, it is a high chance that I am not the best person to speak at your event.* *
Required
What is the audience age group and size? Approximate ranges will work. *
Your answer
Is there anything else you would like for me to know about the event or this request? Please share it here.
Your answer
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