Thanks so much for your interest in having me speak!

please answer the following questions so that we can determine if there is a mutual fit!

event information
event date
event date
contact information
contact name *
contact name
contact phone number
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event details
please include relevant information on other speakers, keynotes, past speakers, etc.
Will there be media coverage? If yes, which media outlets are you expecting to be in attendance?
Will there be event sponsors? If yes, please list all confirmed and invited event sponsors
will your organization offer an honorarium? *
Will your organization cover travel and lodging expenses? *
confirmation deadline *
confirmation deadline
presentation information
What audio/ visual equipment is available? *