Melissa Ambrosini Speaker Request
Please submit your request below. Thank you for thinking of Melissa.
Sign in to Google to save your progress. Learn more
Name *
Email *
Event Website/Company Website *
Event Title *
Event Address *
Proposed date of event *
What is the theme of your event? *
Duration of Melissa's talk (e.g. 30/60 mins) *
What topic(s) would you like Melissa to cover? *
How many attendees are expected? *
What is the male to female ratio of the attendees? *
What is your budget/proposed fee? Please note Melissa does not speak for free *
Will there be an opportunity to sell Melissa's books at the event? *
Why do you think Melissa would be a good fit as a speaker at your event? *
Is there anything else we need to know? *
Clear form
Never submit passwords through Google Forms.
This form was created inside of Melissa Ambrosini. Report Abuse