Contact Name: *

Contact Email: *

Contact Phone Number: *

Name of Organization or Event: *

Date of Event: *

Time of Event: *

Is this event virtual or in-person? *

If this is a virtual event, will it be live or pre-recorded?

Location of Event: *

Please provide a brief description of your event: *

What type of speaking engagement are you interested in having Maria offer? *

Will your organization provide travel accommodations for Maria and her executive assistant to attend your event? (If applicable) *

How long do you expect this speaking engagement to be? *

Will Embrace Her Legacy have the opportunity to have a display table at your event? (If applicable)

How many attendees will be at your event? *

Briefly describe the demographics or profile of your event attendees. (Ex: College Students, Businesswomen, etc.) *

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) *

Do you have a preferred topic you want Maria to discuss? *

What's your budget for speaker honorarium fees? *

Please provide any website or social media links to your organization or event if available.