Booking

Thank you again for thinking of me. I feel honored. Please take a moment to fill out the form below just so that I have all the information needed to understand your event better, have accurate contact information, and understand all logistical elements. Looking forward to connecting with you.

Booking/Speaking Request

Event Organized By

Contact Person (Name)

First Name

Last Name

Contact Email

Contact Phone

(###)

###

####

Event Name

Event Theme / Speaking Title

Event State

Event City

Event Date(s)

Event Time/Duration (From: To)

Event Description

Tell me a bit about the event. Is it a first event or reoccurring? What is the audience like (age range, and any other way you can use to describe them.) The more details you give the more relevant I can make the content.

How much time would you like for me to speak for?

Audience Dress Code

Desired Outcomes (What do you want the audience to walk away with?)

Closest Airport(s) (If Applicable)

Venue Name

Anticipated Number of Attendees

Is there consideration for a speaking fee/honorarium

Speaking and Booking

Booking

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