Shante R. Roddy Speaker Request Form

Shante R. Roddy Speaker Request Form
Contact Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Name of Event*
Presentation Length*
Event Location/Address*
Date of Event*

MonthDayYear
Date
Presentation Start Time*

Hour Minutes

AM/PM Option
Requested Presentation Type*
How did you hear about Shante R. Roddy?*
Audience AnalysisOverview of Audience (career professionals, entrepreneurs, single women, etc.)*
Average Age Range of Audience*
What goals or objectives do you want the presentation to address?*
How do you want the audience to feel after the presentation? (ex. inspired, informed, educated , etc.):*
Speaker Budget*
Additional Comments*
Please verify that you are human*
Should be Empty: