Speaker/Guest Appearance Request Form
Please take a few moments to complete the questions below to request Kimesha to speaker at your event or appear on your show. Kimesha or her assistant will follow-up with you shortly about your request!
Email *
Name *
Email *
Phone
Organization *
How did you hear about Kimesha? *
Required
Event Date *
MM
/
DD
/
YYYY
Event Time *
Time
:
Event Location *
Number of Attendees *
Speaking Topic *
Describe Audience *
What are some challenges they maybe facing? What are some key take-aways you want your audience to leave with. *
Length of Presentation *
Type of Event *
Speaking fee budget *
Discount or Code
Press Kit *
Required
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