Invite Dr. Shana to be a Keynote/Workshop Presenter
Want your attendees to get their SEXY Back?
Point of Contact for event
*
First Name
Last Name
E-mail
*
example@example.com
Phone Number
*
-
Area Code
Phone Number
Date of Event
*
-
Month
-
Day
Year
Date
Name of Upcoming Event
*
Website
*
Type of event
*
Virtual
In person
Type of talk
*
Keynote
Panel
Workshop
Mistress of Ceremonies
Podcast
Other (explain in description box)
Length of talk requested
*
30 minute
45 minutes
60 minutes
90 minutes
other (explain in description box)
Estimated # of attendees
*
Demographics of attendees (i.e. gender/age/other chx traits)
*
Provide a brief description of event and it's mission :
*
What is your budget for the speaking role you are requesting of Dr. Shana?
*
Will travel and hotel accommodations be provided? Reply N/A if virtual event
*
Will Dr. Shana have the opportunity to sell her products or services?
*
Why do you think Dr. Shana is a good fit for your event?
*
Please provide names of other confirmed influencers who will be speaking at this event if applicable
Anything else you want us to know?
*
Attach flyer or promotional information for event
Browse Files
Cancel
of
Submit Form
Should be Empty: