Questionnaire Form for Embrace Her Legacy (Maria I. Melendez, Embrace Her Legacy Founder)
Please fill out this form with as much detail as possible for a quote and confirmed availability for request. Thank you!
* Required
Contact Name:
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Your answer
Contact Email:
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Your answer
Contact Phone Number:
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Your answer
Name of Organization or Event:
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Your answer
Date of Event:
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MM
/
DD
/
YYYY
Time of Event:
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Time
:
AM
PM
Is this event virtual or in-person?
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Virtual
In-Person
Other:
If this is a virtual event, will it be live or pre-recorded?
Live
Pre-recorded
Combination of both
Other:
Clear selection
Location of Event:
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Your answer
Please provide a brief description of your event:
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Your answer
What type of speaking engagement are you interested in having Maria offer?
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Workshop
Series of Workshops
Keynote/Motivational Speech
Panel
Other:
Will your organization provide travel accommodations for Maria and her executive assistant to attend your event? (If applicable)
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Yes
No
Maybe
N/A
How long do you expect this speaking engagement to be?
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1-hour or less
1 - 2 hours
More than 2 Hours
Other:
Will Embrace Her Legacy have the opportunity to have a display table at your event? (If applicable)
Yes
No
N/A
Other:
Clear selection
How many attendees will be at your event?
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Your answer
Briefly describe the demographics or profile of your event attendees. (Ex: College Students, Businesswomen, etc.)
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Your answer
What takeaway do you want attendees to walk away with from this speaking engagement? (Ex: achieve personal goals, leadership development, personal development, build confidence, etc)
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Your answer
Do you have a preferred topic you want Maria to discuss?
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Your answer
What's your budget for speaker honorarium fees?
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$500 - $1,000
$1,000 - $2,500
$2,500 - $5,000
$5,000 - $7,500
$7,500 - $10,000
We do not have a budget for speaker fees.
Other:
Please provide any website or social media links to your organization or event if available.
Your answer
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