Contact Information

1. Tell Me a Little About Your Event

Event Name*
Tentative or confirmed

Event Type*
Conference, retreat, training, team gathering, etc.

When is your event?*

Our date is flexible / we're still exploring.We have a fixed date

Event Date(s)

Expected Number of Attendees*

2. Who Will Be Attending?

Please share a little about your audience, including their roles, goals, or reason for attending.

3. What Kind of Speaking Engagement Are You Interested In?

Select all that apply.

Keynote presentationInteractive workshopPanel discussion or moderated conversationNot sure yet - I'd welcome your ideasOther

4. What Topic or Theme Would You Like Me to Speak About?

What topic or theme would you like me to speak about?*
If you have an event theme or a particular presentation of mine in mind, please include it. It’s also fine if you’re still exploring.

5. What Do You Most Want Attendees to Think, Feel, or Do Differently as a Result of This Session?

What would you most like attendees to take away from the session?*

6. How Much Time Are You Planning for the Session?

Session Length*
An estimate is welcome, for example, a 45-minute keynote or a two-hour workshop. If you’re unsure, let me know.

7. What Budget Have You Allocated for the Speaking Engagement?

Speaking Engagement Budget*
Please share your anticipated speaker fee budget and whether travel and accommodations would be covered separately. If your budget is still being determined, please indicate that.

8. Why Are You Interested in Having Me Speak at Your Event—and Is There Anything Else You’d Like Me to Know?

Additional Information
Optional

9. How Did You Find Me?

How did you find me?
-- Please select --A colleague or friend recommended meI saw you speakSearchSocial mediaEvent or conferenceOther