Kasey Bell: Speaking Request Form

Thank you for considering Kasey for your speaking needs. Kindly fill out the form, and we will be in touch regarding your request at the earliest opportunity.

*Please note: Kasey's travel is very limited, so book EARLY!

First Name

Last Name

Company/Organization/School

Your Title

Phone Number

Virtual or In-Person Required

Virtual

In-Person

Name of Event

Date of Event (first choice)

Date of Event (second choice)

Location of Event

Nearest Airport

Capacity: Please indicate the capacity of the location. Hands-on workshops are usually limited to between 12 and 30 participants, with 20-25 being ideal. Keynotes and breakout sessions may of course include a higher number of participants.

Expected number of participants

Audience

Billing Address

Proposal Approval * Please indicate the name, title, address, email, and phone number of the person who will approve and sign the contract.

Topic(s) Requested/Details of What You Need for Your Event * Please be specific on what topics you would like covered. Please let us know if this is a multi-day event.

Details of Your Needs/Goals

How did you hear about Kasey

Thanks so much! We will be in touch soon!

Kasey Bell: Speaking Request Form

Thank you for considering Kasey for your speaking needs. Kindly fill out the form, and we will be in touch regarding your request at the earliest opportunity. *Please note: Kasey's travel is very limited, so book EARLY!

Thank you for considering Kasey for your speaking needs. Kindly fill out the form, and we will be in touch regarding your request at the earliest opportunity.

*Please note: Kasey's travel is very limited, so book EARLY!