Contact Name
*
First Name
Last Name
Contact Position/Title
*
Contact Email Address
*
Contact Phone
*
(###)
###
####
Company/Organization Name
Company/Organization Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Type of Event
*
Please check all that apply.
In-Person
Live Virtual
Hybrid [In-Person + Virtual]
Recording
Workshop Budget
*
Under $1,000
$1,000 - $2,500
$2,500 - $5,000
$5,000 - $10,000
$10,000 - $20,000
Above $20,000
Workshop Options
*
Which workshop would you or your organization like to host? Please check all that apply
TALK IT OUT
GET INSPIRED
WRITE NOW
SPEAK UP
STAY TRUE TO YOU
MAKING FRIENDS
Customized Workshop Experience [Describe Below]
Customized Workshop Experience
Are you interested in a customized workshop experience? Please provide your learning outcomes?
Event Venue Address
[In-Person] Where is your event being held?
Venue Accommodations
*
Which of these accommodations are you able to provide? Please check all that apply.
Virtual Experience [Online]
Indoor Seating
Outdoor Seating
Adequate Parking
Moveable Tables
Moveable Chairs
Open Program Space
None
Media Accommodations
*
Which of these accommodations are you able to provide? Please check all that apply.
Video Conferencing/Streaming
House Sound System
Spotlight/Stage Lighting
Cordless Microphone(s)
Headset Microphone(s)
Video Sound Plug-In
Screen Projectors
PowerPoint Projection
None
Proposed Date
*
MM
DD
YYYY
Proposed Start Time
*
Production Requires Minimum - 2 Hour Block
Hour
Minute
Second
AM
PM
Additional Information
If you have multiple dates and times for your event please add that information here.