Speaking Request

If you would like to schedule Yolanda Young as a speaker at your next conference or event, please fill out the form below. You may email Jamie.Brathwaite@obabl.com or call 202-756-1847.

 

Primary Contact's Name *

FirstLast

Primary Contact's Email Address *

Primary Contact's Phone Number *

Primary Contact's Mobile Phone *

Secondary Contact's Email

Name of Organization *

Organization Website

Organization Area Focus *

Organization Type*

If other

Additional Organization Details

Role In Event*

Prospective Date of Event - First Choice Date*

Second Choice Date*

Keynote Topic:*

Event Start Time*
:

Start Time of Speaker *
:

End Time of Speaker *
:

Event Name

Event Description*

(name of the event, length of speech, attire for event, format, topic, luncheon, dinner, reception or theater style seating) DO NOT INSERT PRESS RELEASE

Panel Topic*


Panelists: Specific Names and Affiliation

Venue Name*

Address*

Address line 2

City

State/Province/Region

Zip/Postal Code

Closest Airport To Venue*

Audience*

What media outlets (radio, television, newspaper) will be present at this event?

How is the event being promoted?


Organization Will Cover Expenses

 Yes No

Expenses Covered By Organization

 Air Travel Car Service Hotel

Speaker will have products (book, tapes, etc.) available for your event. Would you be willing to provide 2-3 people to help sell Speaker’s products?

 Yes No

Honorarium

 Yes No

Honorarium Amount*

Deadline For Response*

Captcha*

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