Please assist me in ensuring I provide the most valuable experience for your event by completing this short questionnaire, thank you!

Event Information

Name & Theme of Event: *

Date & Time of Event: *

Is this virtual or in person? *

How did you hear about me? *

What specific Topics would you like me to share? *

How many attendees are you expecting? *

Demographics of audience (ie. Gender, age, professionals, business owners, singles, families, etc) *

Is this a paid or free request? *

If paid, what is the budget amount? *

How much time is allotted for my presentation? *

Is this audio and visual, or just audio? *

What are you hoping the audience will receive from this event? *

Typically, I offer my books for sale and offer a consultation for attendees to help extend their learning and their results after I speak, would you like to build in a prepaid amount into your program? *

If not, would I be able to offer my books and/or consultation for sale as a part of my presentation?

Will there be time available for me to speak to interested attendees one on one? *

If so, when?

What other speaker topics will be presented? *

Do you have a promotional flyer? *

First Name *

Last Name *

Phone *

Email *

Organization *

Address

City

State

Postal code

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