Send Jennifer a speaking request: Individual/Organization name * First Name Last Name Website http:// Contact First Name Last Name Email * Event name Event type Event format * In-person or Virtual Virtual In-person Date(s) of event * from MM DD YYYY to MM DD YYYY Format & length of speaking engagement Presentation, panel, both, other (please specify). Details E.g. keynote speech, reading, Q&A, length of presentation/panel. We appreciate any details you can provide. Location (in-person events) Address 1 Address 2 City State/Province Zip/Postal Code Country Estimated number of attendees If this is not a first-time event, please provide a brief list of previous speakers. Are you planning to record the event? Yes No Number of members/email list reach Please include the number of members in your organization and/or the number of people on your email list. Social media presence? Please include social media handles (Instagram, Twitter, Facebook, etc.) and approximate number of followers. Will there be promotions prior to/in conjunction with event? * Will your organization offer payment? If so, please include the amount. If in-person, will your organization cover travel, food, and lodging expenses? Confirmation deadline MM DD YYYY Further information Thank you for your interest! I will be in touch shortly.