Speaking Engagement Request Form (Groups & Organizations)

Quinn Conyers Speaker Request Form

Thanks so much for your interest in having Quinn speak at your event. Please fill out the form below so Quinn will know how she can best speak and serve your audience to her greatest capacity.
REQUESTOR INFORMATION

Please provide your contact details so that Quinn's team can follow up with you promptly on your request.
How did you discover Quinn as a Speaker or Event Emcee? *

Saw her speak or Emcee an event Referral from someone who saw her speak or Emcee Linked In Instagram Google Search Katie Bohrer
Name *

First Name Last Name
Email *
example@example.com
Phone Number *

Area Code Phone Number
Mailing Address (Where can I say a Thank You Card for hiring me as a speaker or Emcee?) *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Company/Organization *
EVENT DETAILS

Tell us about your event so Quinn can get a better understanding of your organization and audience.
Event Name *
Event Date *

Month Day Year
Date
What time does the event start and end? *
What type of event, conference or convention are you planning? *

One day Event Multi-Day Event
How often does your organization or association host events yearly? *

Annually Quarterly Monthly More than 6 events a year
Is this event Virtual, Hybrid or In-Person *
Event Website
SPEAKING ENGAGEMENT DETAILS

Please provide specific details related to your request so that Quinn's team can follow up properly.
How long would you like Quinn to Speak or Emcee? *

Under 20 minutes 30 - 45 minutes Up to an hour Half Day (3 to 4 hours) Full Day (5 to 8hours)
What speaking service would are you interested in booking Quinn for? *

Event Emcee (MC) Keynote Speaker Panel Moderator or Facilitator Pitch Competition Host A combination of 2 services ( i.e. Emcee and Keynote Speaker)
Why would having Quinn Speak or Emcee your event be beneficial? *
Who will Quinn be speaking to?

Please provide information regarding the audience so Quinn can better understand who she is speaking and serving.
Tell me about your audience and event. Be specific (For example... Women entrepreneurs who've been in business looking to scale in 2022). *
How many attendees are expected? *

50+ 100+ 500+ 1000+
Feel free to include any additional comments about the audience that you'd would like Quinn or her team to know:
COMPENSATION INFORMATION

Please provide answers so I can serve you to my greatest capacity
What speaker fee have you allotted for Speaker/Emcee Services for this event or professional development training? *
Thanks so much for your interest in booking Quinn as a Speaker or Emcee for your event! After you submit this form you will be directed to Quinn's calendar. Please book a time so you and her can discuss the details of your event, and how she can transform it into an EPIC experience as an Energetic Emcee or Powerful Presenter.
Please verify that you are human *
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Quinn Conyers Speaker Request Form

REQUESTOR INFORMATION

EVENT DETAILS

SPEAKING ENGAGEMENT DETAILS

Who will Quinn be speaking to?

COMPENSATION INFORMATION