Request edit access
JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Speaker Request
Please complete and submit to request Lady Redelia Fowler to Speak for Your Event or Organization.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Your Full Name:
*
Your answer
Cell Phone:
Your answer
Your business or organization name
Your answer
Name of event/conference
Your answer
Day(s) you are requesting Lady Redelia to speak?
MM
/
DD
/
YYYY
Time you are requesting Lady Redelia to speak?
Time
:
AM
PM
Suggested Honorarium
*
$550 (30 minutes to 1 hour)
$1,200 (2 hour presentation or workshop) Rate increases for 100 plus attendees
$2,500 (1 night stay) Host to absorb: Lodging, meals and travel where required
Proposed Honorarium (suggested honorarium within your ministry budget)
Other:
I have read and agree to the terms of this agreement
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
