Faith + Mama Keynote Speaker Topic Form

Please complete the application below.

Faith + Mama team will be in touch within 72 business hours.

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Full Name *
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Faith + Mama is committed to creating an intergenerational impact in the world, building intergenerational advocacy and education and leaving an intergenerational legacy of healing and liberation. Our ethos and values are guided by our desire to become good ancestors, in honour of those who have come before us, and in service of those who will come after we are gone.
Do you understand, agree, and put into practice the aforementioned statement?
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Are you a first time client? *
If no to previous question, did you complete your communication consultation? *
How did you find out about us? *
What are you interested in? *
We offer a wide range of discussion/topics. All subjects discussed are through extensive learning and training, with completed training or certification.

Which topics are you looking to discuss?

(Choose as many as you'd like)
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Add-Ons (for an additional cost)

Can select more than one 
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What is your goal for this event/session? *
Are there any products you want to giveaway or sell? *
Are you willing, able, and prepared to invest the money required to secure Melissa Philippe for your event?

Speaker prices vary based on travel, budget and event length

Dates are not adjustable once booked and deposit is made

A payment plan is available. Clicking yes below does not bind you to join the program at this time. You will confirm you commitment to joining the program at the time of your first payment (via full payment or payment plan)
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Once appointment has been made and finalised, only partial refunds are allowed.

All sessions are prepped and planned with personalised notes and cards dependent on topic.
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If you would like to have a 15-minute call with a member to ask any questions you may have about the program, please use this link to schedule a call with our team. 
A copy of your responses will be emailed to the address you provided.
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