Best Mental Health Speaker in Tampa, Professional Speaker, Wellness Speaker in Florida, Top Mindset Speaker, Problem-Solving and Fertility, Infertility

"If you can't fly, then run. If you can't run, then walk. If you can't walk, then crawl. But whatever you do, you have to keep moving forward." - Martin Luter King Jr.

PRE-EVENT QUESTIONAIRE

The pre-event questionnaire provides me with more information about your event. Once the questionnaire is complete, you will receive an email from Encourage and Empower Wellness to detail the next steps. I am looking forward to working with you!

Company/Association: (please also provide information about the company)

Company/Event Website:

Contact’s Name and Title:

What is your role with planning the event?

Contact’s Address/City/State/Zip:

Contact’s Email:

Contact’s Phone:

Event Location- City/State/Venue:

Date of the Event:

What Date and Time would Dr. Squires speak?

Purpose of meeting/event:

Demographic and Profile of Group(s) to be spoken to:

What is your budget? Is travel/logging included for the speaker, PLUS one assistant? What is the closest airport? Will ground transportation and meals be provided? (Dr. Squires travels from Tampa, FL)

What exactly would you like Dr. Squires to do? (i.e., keynote, conference workshop, private business seminar)? Is there more than one appearance requested? What topic would you like her to address?

How long would the presentation last?

Additional comments:

How did you hear about Dr. Squires?

Thank you for submitting! You will receive a response within 24 to 48 hours.

"If you can't fly, then run. If you can't run, then walk. If you can't walk, then crawl. But whatever you do, you have to keep moving forward." - Martin Luter King Jr.

PRE-EVENT QUESTIONAIRE

Explore

Home

About

Coaching

Speaking

Connect

Forms

Terms & Conditions

Privacy Policy

Comment Card