Speaker Invitation Form - Shakeisha Johnson
Which of the following are you requesting?
Will you be requesting any of the folowing?
Digital material (Powerpoint, video, etc.)
Printed worksheets or other printed material
Your Contact Email
Your Contact Phone Number
Name of Organization or Ministry
Organization or Ministry Website
Name of Requested Event or Conference
Theme(s) and/or Focus of Gathering
Date of Event
Expected Number of Attendees
Street Address Line 2
State / Province
Postal / Zip Code
Please indicate your proposed budget for this request.
Will Hotel and Travel Expenses be covered?
Number of Speaking Sessions Requested
Please List The Day(s) and Time(s) You Would Like Shakeisha to Speak
Will There be a Resource Table Available?
Will There be a Volunteer Available to Run the Resource Table?
Yes, we will have a volunteer available.
No, Shakeisha will need to provide someone to run their resource table.
Additional Relevant Information or Requests
Should be Empty: