Event/Speaking Request for Dr Joe

Event/Speaking Request for Dr Joe

Thank you for your interest in bringing Dr. Joe Dispenza to your event. Due to the quantity of applications received, only applications completed in full will be reviewed. If this event is of interest, we will connect with you directly.

Today's Date

Contact / Organizer Name*

Contact Title / Role*

Company Name*

Website*

Email Address*

Phone Number*

How did you hear about us?*

Event Venue?*

Event City*

Event Country*

Proposed Event Dates*

Event Subject / Title*

Is this a Public Event or a Corporate Training type event?*

3rd Party Public Event

Corporate Training Event

Names of other speakers at this event, if known*

Is this the first time you have contacted us about a lecture inquiry?*

Yes

No

Have you worked with us before?*

Yes

No

How many will be in the attendance?*

What day & time would Dr. Joe be required to arrive?*

What day & time would Dr. Joe be required to depart?*

Please list total amount of speaking days/hours*

Briefly describe this event and type of content*

Proposed Ticket Price?*

Have you ever run an event like this before?*

Yes

No

If so, please list the last three you have done?

Have you ever attended one of Dr. Joe’s events?*

Yes

No

How familiar are you with Dr. Joe’s work?*

Do you have an elist? If so, how large is it?*

Event Translation Languages*

Objectives / Comments / Questions*

Are there any documents that you would like us to consider in making a decision?

Drag and drop files here or

Send me a copy of my responses

Powered by

Privacy Notice|Report Abuse