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?

- Area Code Phone Number
What organization do you work with?
Your role / title there:
Tell me a little about the event...
Title / Name of the Event
Location of Event
Is the event one day or multiple days?

One day Multiple days
What's the date of the event?
What date does the event start?
What date does the event end?
Is there a website for the event?
www.ourawesomeevent.com
Tell me a little bit about your event? What are your goals? Who is your audience? This info helps me to help you create an awesome experience for attendees. :)
Is there anything you'd like to upload?

Browse Files

Cancel of
What would you like my role to be? (speaker, host a workshop, webinar, etc.)
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.

Your feedback is important, how was your experience?

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Worst						Best

Tell me a little about the event...