Title *

Phone Number *

Email *

Name of Company or Event *

Date(s) of Event *

Name of Event Venue *

Address of Event *

Nearest Major Airport to Venue

What is your budget for this presentation? *

Do you intend to record or live stream this event? *
YesNo

Speaking Topic *

Length of Presentation needed *

Multiple Presentations Needed? *
YesNoYet to be determined

What is the expected attendance at your event? *

Who are these people? *

What are 3 major challenges these people are facing?

What action do you want this audience to take after this presentation?

Any additional information you desire to share?