Speaking Request - Jamie Kern Lima

Contact Information

Contact Person*

Contact Phone*

Email*

Title

Organization*

Please provide active social media links for your organization.*

Venue (or Virtual Platform)

Event location (City, State, Country)*

Closest airport to event (if applicable)

Expected attendance (how many people do you expect at this event? Please also describe the demographics of your expected audience).*

Please provide an estimate of your organization's budget for the speaker's honorarium*

Event Date (please list all possibilities and options for consideration)*

Time of event*

Please describe the capacity in which you're interested in working with Jamie at your event? (Select all that apply.)*

Keynote Speaker
Q&A Session
Interview
Meet & Greet
Lunch, dinner, or other private gathering with your event team, board members, or other VIP guests
Other

Please provide any additional details we should know about your request, your organization or your event?

Name

This field is for validation purposes and should be left unchanged.