Speaker/Training Inquiry Form
Please fill out the form below to inquire about speaking opportunities. To see more about my topics you can check my speaker website: https://bit.ly/RPspeaker
Contact Information
Full Name
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First Name
Last Name
Organization/Company
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Position/Title
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Email Address
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example@example.com
Phone Number
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Please enter a valid phone number.
Preferred Method of Contact
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Email
Phone
Event Details
Event Name
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Event Date(s)
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Month
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Day
Year
Date
Event Location (City and Venue or online)
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Type of Event
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Conference
Workshop
Webinar
Seminar
Training Series
Other
Estimated Audience Size
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Audience Demographics (Industry, Job Titles, age, gender etc.)
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Will you share names and contact details of the participants for follow up?
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Yes - we will share the contacts with the speaker
No - we don't share contacts
Let's discuss
Not sure
Many organizers like to include copies of Ruth's book Be Hopeful, Be Strong, Be Brave, Be Curious as part of the participant package. It is available in print, Kindle, and audiobook. How many copies do you want for your audience? (Please note you can order them at a discount from Amazon or you can work with Wiley, my publisher, to arrange the copies to be delivered to you. They offer discounts on bulk orders.
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Session Details
What you are hoping for from the session.
Desired Topic(s) or Key Focus Area(s) (check out my speaker website to see examples)
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Preferred Session Format
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Keynote
Workshop
Breakout
Panel Discussion
Other
Desired Duration (in minutes)
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How will you measure the success of the event/session?
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Additional Notes or Requirements
Will I be able to bring a videographer to record my session?
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Yes
No
We will record and provide a copy
We will record but won't provide a copy
Not sure
Submit
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