Keynote Speech Intake Form
This short intake form helps us tailor Herman’s presentation to the goals of your event and the needs of your audience. By sharing a few key details, you’ll help us ensure the message is timely, relevant, and impactful.
Event Name
*
Contact Name
*
First Name
Last Name
Contact Email
*
example@example.com
Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Event Date:
*
Event Location
*
What is the overall goal or focus of the event?
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e.g., leadership development, company anniversary, annual retreat, industry conference
Who will be in attendance?
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e.g., board members, C-suite executives, employees, students, community leaders
What is the primary purpose you would like Herman’s speech to serve?
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Please Select
Inspire and Motivate the Audience
Educate and Equip the Audience
Strategize and Problem-Solve with the Audience
Other
Other Purpose:
Which primary theme would you like Herman to focus on during his speech?
*
Please Select
Leadership Excellence
Building High-Performance Teams and Culture
Legacy and Personal Brand Development
Adaptability Innovation and Resilience
Entrepreneurship and Business Growth
Other
Other Theme:
Herman incorporates personal storytelling into all of his speeches. Are there any types of personal stories you believe would resonate most with your audience?
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Overcoming Educational Challenges and Academic Growth
Leadership and Team Building Experiences
Entrepreneurship and Business Lessons
Professional Sports Journey (e.g. Detroit Lions NFL)
College Athlete Experience (e.g. University of Virginia)
Youth Sports and Early Life Lessons (e.g. Danville beginnings)
Community Impact and Philanthropy Stories
Mentorship and Guiding Others
Other
What is the desired audience takeaway?
*
What do you want the audience to feel, know, or believe after the presentation? (e.g., inspired to lead, empowered to adapt to change, motivated to drive results)
Are there current challenges or recent successes surrounding the event or organization?
*
(e.g., high turnover, company growth, leadership transition, industry awards)
Submit
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