Speaker Request Info

Speaker Request Info

Jess Birken, MNM, Esq.
Hi! What's your name?

First Name Last Name
Your best email address:
Best phone number to reach you at?
What organization do you work with?
Your role / title there:
If we work together, who will sign the speaking agreement?
Signer's Name

First Name Last Name
Signer's Title
Tell me a little about the event...
Title / Name of the Event

Address for Event (if known)

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Event start date:
Event end date:
Is there a website for the event or for your organization?
I want to help you create an awesome experience for your attendees! What are your goals? Who is your audience?
My work for you:
How many individual sessions would you like to book me for?
Which of my sessions are you interested in? I offer talks and workshops.
The following can be presented as 30-60 min seminars or short "TED" style talks

5 Rules to ImproveYour Life and Your Law Practice* Client Consultation Makeover Growing Your Practice Through Digital Information Products How to Create an Award-Worthy Website Without Breaking the Bank Zapier 101 - Let the Robots Run Your Firm Take Back Your Schedule & Create Happy Clients with Online Scheduling* Why I Switched to Subscription Legal Services (and how you can too)* 10 Things Every Lawyer Should Understand About Nonprofits Think Twice: Look Before You Leap into Nonprofit Board Service Master Online Marketing The Fast & Easy Way Top Tech Tips for Busy Solos
The following workshops are between 2 - 4 hrs

Hack Your Practice (TM) Workshop Client Consultation Makeover Workshop YouTube Workshop - Make Your First Video!
What is your budget for engaging my services?
How many nights of lodging are covered?
- Local full day rate $1,500 (Metro or less than 3 hr drive)
- Travel full day rate $2,500 (more than 3hr drive or air travel) PLUS travel expenses
What happens now?

Using the information you provide here, we will reach out to you by email and phone to follow up with you. Want to skip the phone tag? Feel free to book a call time with Meghan to talk through options and costs.

How can we improve?

Your feedback is important, how was your experience?

	1	2	3	4	5
Worst						Best

What doesn't work, please let me know so we can fix it.
Should be Empty:

Speaker Request Info

Tell me a little about the event...

My work for you: