Contact Information

Full Name *

Email *

Phone *

Organization / Company Name *

Organization Website

Organization Social Media Links

Event Overview

Event Name *

Event Date(s) *

Are these dates flexible?

Event Location *

If In-Person – City & State

Estimated Audience Size *

Proposed Speaking Duration *

Audience & Goals

Describe Your Audience *

What is the primary goal of this session? *

What should attendees walk away knowing, feeling, or doing? *

What challenges is your audience currently facing around money, leadership, or operations? *

Topic & Format

Topic of Interest *

Session Format *

Will this session be recorded or livestreamed? *

Logistics

Will A/V support be provided?

Do you require slides, handouts, or pre-event promotion materials?

Investment

Is there a speaker fee budget allocated? *

If yes, what is the budget range?

Will travel, lodging, and meals be covered if applicable?

Final Details

Anything else we should know?

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