First Name *

Last Name *

Company or Organization

Job Title

Website

Email *

Phone *

Secondary Phone

Tell us about you and your organization

Please describe your event

I'm interested in having Beate speak at: (choose one ore more)

A live television event

A live radio event

A live corporate event

A live college event

A live community event

A live online event

A live event (other)

A recorded interview for television

A recorded interview for radio

A recorded interview for a telesummit/online event

A recorded interview for a blog

A recorded interview (other)

What topic would you like Beate to speak on?

Business & Entrepreneurship

Business: How to Become the Authority in Your Industry

Business: Other

Women: Lead Don't Beg

Women: Other

Resilience

Not sure, let's discuss

Event / Interview Dates

Do you have a speaking budget for this event?

Yes

No

Are you a Non-Profit Entity?

Yes

No

What is the anticipated size of your audience?

Can Beate make an offer from the stage?

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