SpeakUpSis! Experience
The Speak Up Sis® Experience with Angel Charmaine is transformative and life altering for women. It provides a protected space and opportunity to have authentic, robust conversations with other women to foster resilience and combat mental health concerns like anxiety and depression as well as the everyday "hard things" of life within a group setting. Please complete the following information in its entirety to the best of your knowledge. Note: SpeakUpSis® Experience is for women/girls only.
Contact Name
*
First Name
Last Name
Email
*
example@example.com
Contact Phone Number
*
-
Area Code
Phone Number
Business/Organization Name (N/A if not applicable)
*
Business/Organization Type
*
Church/Ministry
Womens Group/Organization
Personal/Family & Friends
Business Event
Other
Business/Organization Website (N/A if not applicable)
*
Primary age group of attendees (If mixed group, select the two that best represent the majority of women in the group.)
Teens (14-18)
Young Women (18-25)
Older Women (26-39)
Seasoned Women (40+)
Group Size
*
5-10
10-20
20-30
Preferred Event Date
*
-
Month
-
Day
Year
Date
Preferred Event Time
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1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
City & State of Event
*
Preferred Experience Type
*
Facilitated Discussion with book
Facilitated Discussion with performances
Keynote Speaker (Angel Charmaine)
Guest Speaker (Angel Charmaine)
Unsure
Do you have a budget for this event?
*
Yes
No
Theme or focus of the gathering
*
How did you hear about SpeakUpSis Experience?
*
I was an attendee
Someone told me about it
Facebook
Instagram
Other
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