Burnout Relief and Speaker Inquiry Interest Form

Thank you for your interest! We look forward to learning more about you and your team needs.

Please complete this short form and a member of our team will be in touch within 2 business days. Stay on the lookout for an email from info@hookywellness.com.
Are you seeking support of yourself or your team?*

A group of peopleMyself
Since you are seeking support for yourself, please click here.
First Name*
Last Name*
Email*
example@example.com
Organization/Company Name*
Is your company/organization a nonprofit or an educational institution?*
What is your title?*

DEI leaderEmployee Resource Group leadFunctional lead (i.e. Director of Marketing, VP of sales, etc.)Employee BenefitsHuman ResourcesTeam AdministratorWellness/Employee Well-beingOther, please specify
Who is the audience you are looking to support?*

Working TeamEmployee Resource GroupEmployees Across the OrganizationOther, please explain
Do you have a preferred format of support for this speaking engagement?*

KeynotePanelFireside ChatWorkshopOn-demand digital contentFlexible/Unsure
Do you have a specific date in mind?*
What is the event date?*
MM/DD/YYYY
If you don’t have a specific date in mind, what month and/or time of year do you have in mind?*
How many people are you looking to support? What is the estimated number of attendees:*

Less than 1010-2021-5051-100101+
Describe the current situation and how it is impacting you and your target audience.*
What are your goals for a successful program/event?*
Why have you decided that NOW is the right time for support?*
If you could wave a magic wand, how will this program impact your target audience?*
What is your investment budget for support?*

Less than $5000$5001 to $10,00010,001 to $25,000$25,001 to $50,000$50,001+
How were you introduced to Hooky Wellness?*

ReferralLinkedInInstagram/FacebookPress or podcast interviewsA member of the Hooky Wellness teamGoogleHooky Wellness WebsiteUnsure/Don’t recallOther, please specify
Please share the person or business or platform, that introduced you to Hooky Wellness.*
If you don't remember, just say, "I don't remember."
May we add you to our newsletter list?*
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