Speaker Request Form
Please share how Mindfulness for the People can meet your needs for a public speaker.
Email address *
Name *
Your answer
Your Title & Organization *
Your answer
Event Date *
MM
/
DD
/
YYYY
What is your approximate talent budget? *
Type of Event *
Your answer
Event Location *
Your answer
Topic requested for talk: *
How would you describe the audience's exposure to or experience with mindfulness trainings? *
No exposure
Lots of advanced training
How would you describe the audience's *interest* in mindfulness trainings? *
Not interested at all
Very interested and excited!
How would you describe the audience's exposure to or experience with compassion-based trainings? *
No exposure
Lots of advanced training
How would you describe the audience's *interest* in compassion-based trainings? *
Not interested at all
Very interested and excited!
Additional information about your event or request:
Your answer
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