SPEAKING REQUEST FORM

SPEAKING REQUEST FORM

Please provide details about your request and our team will review your submission and respond within three business days. Thank you for your interest—we look forward to the opportunity to support and deliver an impactful experience.
What services are you seeking?
Your Email
example@example.com
Name

First NameLast Name
Company/Organization/Group
Website Address
Date of the Event

MonthDayYear
Date
Location of the event if live
Number of Attendees
What capacity/role would you like Dee to participate?
What is the topic/theme you would like Dee to speak about?
What time will Dee speak and how long?
What is the proposed professional fee/honorarium allocated for Dee?
What expenses have you budged for Dee's travel and accommodations (if outside of the New Jersey/New York metro area)?
Is this a ticketed event?
What is your Promotion Plan? Internal or External [NOTE: If we accept our team requests review of any promotional collateral with Dee's likeness before distribution.]
Will this event be recorded?
Will a professional videographer and/or photographer be present?
Do you agree if video and photos are taken including Dee, you will provide our office with a copy?
If Dee isn't available are you open to someone else on our Diverse & Engaged or AI Training Plus team?
We do not authorize the use of any likeness to Dee C. Marshall (ie. photos, videos or content from the public domain - internet, social media pages, web pages including our properties). Upon acceptance, we will provide a professional high-res head shot and bio for marketing purposes. Do you agree to honor our request?
www.diverseandengaged.com > ctanner@diverseandengaged.com > 973-755-6700
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