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Booking Request Form

Please complete and submit this form to request Esther Mwema’s participation at your upcoming event. This form will be reviewed by Esther Mwema and her team within 5 working days. 

Section 1: Request Details

Deadline for Response: When do you need a response from the speaker?

Booking Type

Booking Type
A
B

Booking Type

Artist Booking

Artist Booking

Digital Inequalities Expert Booking

Digital Inequalities Expert Booking

Event Format Requested

Event Format Requested

Travel Requirement

Travel Requirement
A
B
C
D
E

Please indicate which of the following is covered by the organizers

Please indicate which of the following is covered by the organizers

Is there a compensation for this speaking event?

Is there a compensation for this speaking event?

What is your budget, if any?

If the speaker is available, will you provide

If the speaker is available, will you provide

Section 2: About You

Your Name

Title

Name of Organization / Institution / Collective

Phone number

Email Address

Organization or Event Website / URL

Information about your organization and the event agenda, theme or other invited guests

What do you want Esther Mwema to speak about - or what impact do you want her to have on your event?

Section 3: About the Event

Event title

Date of Event

Proposed session slot time

Proposed Speaking duration

Who are the expected attendees / audience?

Expected number of attendees in the session / event?

Will there be a Q & A?

Will there be a Q & A?
A
B
C

Are presentation materials needed

Are presentation materials needed
A
B
C

Attendance requirements for speaker

Attendance requirements for speaker
A
B
C

Are attendees paying to access the event?

Are attendees paying to access the event?
A
B
C

Primary Event Sponsor / Host

Primary Event Sponsor / Host

How long has the event been in existence?

How long has the event been in existence?
A
B
C

Section 4: Media and Event Coverage

Is the event open to the public?

Is the event open to the public?
A
B

Are media representatives invited?

Are media representatives invited?
A
B

Will the event be publicised on social media?

Will the event be publicised on social media?
A
B

Will the speaker receive audience feedback after the event?

Will the speaker receive audience feedback after the event?
A
B
C

Will the event be broadcast or streamed?

Will the event be broadcast or streamed?

Will the speaker receive any recordings or photos after the event?

Will the speaker receive any recordings or photos after the event?

Will there be a photo approval or release form?

Will there be a photo approval or release form?
A
B