SPEAKING REQUEST QUESTIONNAIRE

SPEAKING REQUEST QUESTIONNAIRE

Thank you for considering BPM Wellness to speak at your event! Let's start the conversation.
Contact name*

First NameLast Name
Contact Email*
example@example.com
Contact Phone Number*

Area CodePhone Number
Name of Your Organization*
How did you hear about BPM Wellness?*
Name of your event*
Describe the event you wish BPM Wellness to participate in*
How many attendees do you expect for your event?*
Would you like BPM Wellness to present in person, virtually, or a hybrid of both?*
Are you interested in a recording of the event for limited internal use within your organization? (Media release and agreement required)*
How many times do you wish BPM Wellness to speak at your event?*
Are you interested in bundling with any other BPM Wellness Organization or support Services?*
What is the budget range that your company has available to hire BPM Wellness for this event?*
Would you like the presentation to be co-branded and include your company logo?*
Would you like printed copies of the presentation or any other type of giveaway or handout?*
Often audiences reach out for support after hearing BPM Wellness speak. Do you have an EAP or other 3rd party support that BPM Wellness should refer to?*
If you do not have an EAP, would you like to discuss a time allotment for BPM Wellness to assist any employees who reach out?*
Speaking Date(s)*
Speaking Time(s)*
Thank you for filling out this speaking engagement questionairre. We will review your information and get in contact with you soon! (If you completed this form in the fillable PDF format please email the completed copy to twilliams@bearingpointwellness.com)
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