Speaking Request Form
Thank you for your interest in having me speak at your event. It is an honor to be considered! I will prayerfully consider your event and will get back to you very soon with next steps. All requests must be directed through this form in order to help with keeping dates and information organized. Thank you for kindly complying!
Organization or church name *
Your answer
Organization/church location *
Your answer
Organization website
Your answer
Your name *
Your answer
Your position or title in the organization *
Your answer
Your email address *
Your answer
Your phone number *
Your answer
Speaking date(s) requested *
Your answer
Is your date flexible? *
How many attendees do you expect? *
Your answer
Who else (if anyone) is on the agenda to speak at the same event?
Your answer
Please tell me a little more about your event and your audience *
Your answer
What type of event is this? *
How many sessions would you like Michelle to do and how long is each? *
Your answer
Describe your event theme (You may leave blank if you haven't chosen this yet)
Your answer
Please list any special requests for Michelle, or leave blank if you have none.
Your answer
Budget range *
Your answer
Closest major airport
Your answer
Who spoke for your last event, and what was your theme? *
Your answer
How did you hear about Michelle? *
Your answer
Is there anything else you'd like Michelle to know?
Your answer
When you are finished, please click the submit button. Thank you!
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