Speaker Inquiry Form Name * First Name Last Name Organization * Role * Email * Phone * (###) ### #### EVENT DETAILS Event Name Event Date MM DD YYYY Event Location Address 1 Address 2 City State/Province Zip/Postal Code Country Is this a confirmed event, or are you still in the planning phase? Confirmed Still Planning What is the format of the event? Check all that apply In-person Virtual Hybrid Length of Keynote Desired AUDIENCE & GOALS Who is your target audience? i.e. demographics, interests, professions What is the overall theme or goal of the event? Expected Number of Attendees Who else is confirmed to speak? BUDGET & LOGISTICS What is your speaker budget range? <$2k $2k to $5k $5k to $10k $10k+ Will travel and accommodations be covered? What is the timeline for your speaker selection process? NEXT STEPS How did you hear about Leigh? What are some key messages you want your audience to take away from the event? Thank you for your submission! We will send over a proposal ASAP.
