Synergistic Solutions Speaker/Presentation/Facilitation Inquiry

Please complete the following information expressing interest in inviting a member of our firm as a speaker, presenter, or facilitator for your organizational needs. This includes B2B partnerships for professional development programming.

What are the dates being considered for this speaking engagement?

Organization/Institution Name

Name of Point of Contact

Point of Contact's role within your organization

Best Phone Number for Point of Contact

Desired Topics/Areas for Synergistic Solutions to Address

If you selected 'Other', please describe below

What is the budget allocated for this speaker request (provide a range from basement to ceiling for speaker fees)?

What is the budget allocated for the speaker's flight, hotel, and rental car/ground transportation (if virtual, indicate n/a)?

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