Charlene Ridley Speaker Request Form
Complete this form to have Charlene speak at your event. Responses will be sent within 2 business days of submission. For questions regarding this form, please email charlene@unpauseyourdreams.com
Name
*
First Name
Last Name
Organization
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Website
*
Event Details
Name of Event
*
Purpose
*
Date of Event
*
-
Month
-
Day
Year
Date
Time of Event
*
Hour Minutes
AM
PM
AM/PM Option
Delivery Method
*
Virtual
In-person
If in-person, provide location (City, State)
Participation Format
*
Keynote
Workshop
Panel
If you are looking to book Charlene for a workshop please define:
90 Minute HEART Goals Team Training Workshop
Half-Day HEART GOALS Training Workshop
Full-Day HEART GOALS
Signature Keynote
*
HEART Goals™: Elevating Employee Well-Being and Performance (SHRM Accredited)
HEART Goals™: Driving Leadership, Innovation, and Impact:
Monetize What You Know: Turning Your Expertise Into Income
Length of Talk
<50 Minutes
50-70 Minutes
90 Minutes
Budget (Please exclude travel & lodging in this budget. Allow for Non-stop, Direct Flights from Charlotte Douglas Int'l and Marriott Convoy/Hilton hotels)
*
Anything else you want to share about the event.
Submit
Should be Empty: