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Events & Speaking Form

Name

Email

Mobile

Date of event

Event style

Expected audience size

Theme of the event

Are you looking for a Keynote, a Workshop, or a Physical Exhibition?

What is the "One Big Shift" you want your audience to feel after Susanne speaks?

Outside of the speaking element, are there any other engagements that you require?

What is your budget for the event?

What are your social media links?

If required, accommodation and travel will be covered by the requestor/organisation for Susanne and team (if needed). Do you understand?

If required, accommodation and travel will be covered by the requestor/organisation for Susanne and team (if needed). Do you understand?

In addition, we may require event passes for team members (if required). Do you understand?

In addition, we may require event passes for team members (if required). Do you understand?

Susanne and her team may have media presence during the event and permission to use footage from the event on any social media and community accounts is permitted. Do you understand?

Susanne and her team may have media presence during the event and permission to use footage from the event on any social media and community accounts is permitted. Do you understand?

How did you hear about us?