Speaker Request
Thank you for an inquiry to book Bahiyah Shabazz as a speaker at your event.

We are happy to learn more about the event, provide a quote, discuss availability, and anticipated participation as a speaker.

Please provide detailed responses which may include N/A or TBD for the following questions.
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Your Name and Title: *
Email Address: *
Organization's Name *
Organization's Website *
Organization's Status *
Required
Event's Location: *
Event's Theme: *
What would you like attendees to get out of the event? *
Date of Event: *
MM
/
DD
/
YYYY
Time of Event: (Please provide in CST) *
Time
:
Expected number of attendees: *
Is the event free for attendees? *
If a paid event, what is the admission price? *
Are there sponsors for the event? *
Type of presentation requested: *
Budget for requested speaker: *
Are there special requests? Please check all that apply: *
Required
Can the speaker sell books &/or memberships at the event? *
Please provide additional comments for the speaker. *
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