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Keynote Engagement Inquiry Form
Contact Details
Fields with * are required.
First name
*
Last name
*
Email
*
Engagement details
What is the title or theme of your upcoming event?
What specific topic or message would you like the keynote to focus on?
*
Who is your target audience for this event
Executives
Non-profit leaders
New managers
Other
What is the event date and time?
*
Month
Month
Day
Year
Time
:
Hours
Minutes
AM
What is the event location?
What is the desired duration of the keynote?
30 min
60 min
Other
How many attendees are you expecting?
What would success look like for this keynote from your perspective?
*
Do you have a budget range allocated for this engagement?
How did you hear about Willful Change?
*
Google search
Social media
Website/blog article
Email newsletter
Friend or family member
Client referral
Other
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