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Speaker Request
Interested in chatting about a speaking engagement?
Please complete the form below.
* = Required Field
First & Last Name*
Email*
Company/Organization*
Phone Number*
Status of Company/Organization:*
For Profit
Non-Profit
Name of Event*
Date & Time of Event*
PICK TIME
Address/Location*
Type of Event* (Ex: Brunch, Workshop, Conference)
This event will be :*
In-Person
Virtual
Expected Number of Attendees*
Please list any event sponsors :
MEDIA: Will media be invited? If so, please provide the media list.
Cost of Attendance (Please include member and non-member price, if applicable) *
What is your speaker budget?* (Include exact $ amount or range)
How would you like for Joy to contribute to your event?*
Keynote Speaker
Workshop Facilitator
Trainer
Panelist
Host/MC
Other
How long will you need Joy to speak?*
Presentation/Speech Topic Preferred* (Ex: Relationships, Self-Esteem, etc. ))
Will this speech be followed by a Q&A session? *
Yes
No
Will Joy be allowed to promote any of her products/services?*
Yes
No
...Let's Discuss it!
Will travel accommodations be needed? Joy is located in Coconut Creek, FL
Yes
No
N/A
Deadline for Acceptance (please provide exact date) *
How did you hear about Joy?*
Additional Details
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