Interested in Booking Mimi Brown for YOUR Next Event?
Check Mimi's available dates by completing the form below:
Contact Name *
Your answer
Contact Email *
Your answer
Company or Organization Name *
Your answer
Contact Phone Number *
Your answer
Best Time to Contact You *
Your answer
Date of Event- Date, Time of Keynote, as well as Requested Arrival and Departure Times *
Your answer
Location of Event, Venue, City & State *
Your answer
Expected Attendance? *
Your answer
Budget for Speaker? *
Your answer
Who was your speaker last year? *
Your answer
What would Mimi's role in the event be? Provide a detailed description of the event and attendees *
Your answer
Tell us more about the objectives of this event... Do you have a theme for the event? *
Your answer
What is the biggest challenge your organization and the attendees have that you'd like addressed? *
Your answer
How did You Hear About Mimi? Who can we thank? *
Your answer
Submit
Never submit passwords through Google Forms.
This form was created inside of Amp Up Success.