SPEAKING REQUEST QUESTIONNAIRE

SPEAKING REQUEST QUESTIONNAIRE

If you or your organization/company would like to request Dee C. Marshall, CEO of Diverse & Engaged for a speaking engagement or appearance, please complete the attached questionnaire and return it to Stefani@DiverseandEngaged.com and we will get back to you within 3-5 business days
Your Email*
example@example.com
Name

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

MonthDayYear
Date
Location of the event
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 speaker fee/honorarium allocated for Dee?
What expenses have you budged for Dee's travel and accommodations?

Hotel AccommodationsAir TravelGround TransportationType option 4
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 to provide a copy of the photos and video to Dee?*
If Dee accepts, we will provide a professional high-res head shot, and written/ 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.) Do you agree to honor our request? *
www.diverseandengaged.com > Stefani@diverseandengaged.com > 973-755-6700
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