SPEAKING REQUEST QUESTIONNAIRE Corporate

SPEAKING REQUEST QUESTIONNAIRE

Thank you so much for considering Dee C. Marshall, CEO of Diverse & Engaged for your next event. Please complete this form to request her for an appearance or speaking engagement and we will respond within 3-5 business days.
Name*

First NameLast Name
Company/Organization*
Phone Number*

Area CodePhone Number
Email *
Company/Event Website*
Department*

Talent Management/HRDiversity & InclusionLearning & DevelopmentBRG/ERG/Affinity GroupSupplier DiversityOther
Name of the Event/Theme *
Date of Event*
Who is the audience group?*

Mid Level LeadersExecutive LeadersWomen LeadersMid Level ManagersBRG/ERG/Affinity GroupExternal SuppliersExternal Clients/CustomersExternal ConsumersSuppliersOther
Number of Attendees Expected*
In what capacity would you like Dee to contribute?*

Breakout SessionWorkshopKeynotePanelModeratorConference Emcee
What would you like Dee to cover?*

Black Cultural Competency for Non-Black PeopleWhat to Say and NOT Say to Black peopleBecoming an Ally for Black TalentMoving from Uncomfortable to Comfortable Conversations Around RaceManagement 101 for New ManagersExecutive Presence for Women ProfessionalsPersonal Mastery for Winning ProfessionallyPersonal Branding for The Working ProfessionalNetworking and Building RelationshipBecoming Your Authentic SelfBringing Your Best Self To WorkEntrepreneurship to Business Ownership
How long is Dee's talk time?*

30 Minutes or less90 MinutesHalf-Day SessionFull-Day Session or greater (email Dee@DiverseandEngaged.com)Other
Is this a live or virtual event?*
*NOTE- For Dee to appear live/in person, coverage of round trip first class air travel, hotel accommodations, and ground transportation are required for Dee plus one.
Will this event be recorded?*
What is your speaker budget that you are prepared to compensate Dee C. Marshall, CEO of Diverse & Engaged? (NOTE: Rates are virtual or live based on Dee's value as a CEO, subject matter expert, seasoned professional, media contributor, thought leader and consultant to Fortune 10 Executives.)*
Upon acceptance of your request and a formal agreement we will provide a professional high-res head shot, written and read-it bio for marketing purposes. We do not approve nor authorize any likeness to Dee C. Marshall or Dee C. Marshall photos, videos or content from the public domain (i.e. internet, social media pages, web pages, etc.) for use in any of way. Do you agree to honor our request? *
www.DiverseandEngaged.com | 973-755-6700 | Stefani@DiverseandEngaged.com
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