We are excited to learn more about how we can support your upcoming speaking engagement.

Please use the form below to share details and our team will get back to you within 3-5 business days.

What is the name of your organization?

Address

City *

State *

Zip code *

Contact First Name *

Contact Last Name *

Phone Number *

Email Address *

Title/ Role in Organization

Please share a few sentences about the topic of the requested speaking event *

Event Date

Start Time

Event Type *

Presentation Format *

Presentation/ Speech Details

Will the session need to be followed by a question & answer session *

Yes

Audience details: Approximate expected size of audience. Briefly describe the makeup and if membership is required to attend *

Honorable Guests (List names of members of prominence, VIPs, participating in or attending the event)

Media (Will media be invited?) I f so, will the event be open or closed press.

Budget for the Event (Please note that Dr. Uwemedimo's speaker fee starts at $5000) *

Please share the deadline for acceptance of your speaking request. *

Is there any additional information to share that I should know about?