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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
*
Email
*
Company/Organization/School
*
Your Title
*
Phone Number
*
Type of Service
*
Required
Conference Presentation
Keynote
Workshop
Retreat
Other
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
*
Send
Thanks so much! We will be in touch soon!
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