Engagement Requests

We’re excited to learn more about how we can partner to support your inclusive workplace and leadership journey.

To connect you with one of our team members, please complete and submit the following information.

Engagement Requests

We’re excited to learn more about how we can partner to support your inclusive workplace and leadership journey.

To connect you with one of our team members, please complete and submit the following information.

"*" indicates required fields

Date form submitted*

Requesting Company / Organization*

Organization Type*

Company/Organization Website*

Company Address*

Street Address City State ZIP Code

Contact Name*

Contact Title*

Email address*

Phone #*

Engagement Type*

If Speaking, name and description of event

Keynote

Fireside Chat

Panel Moderator

Panelist

Approximate number of attendees

Are you interested in a pre or post appearance

(Q&A, Reception, Meet & Greet, etc.)

If yes, please describe.

Are there other potential or confirmed speakers for this event?

Please list other potential or confirmed speakers for this event

Media - will there be media present?

If Yes, which media outlets?

Is there a charge for attending this event (Ticket price)

Ticket Price

If custom Consulting / Advisory, please describe current situation/challenges, desired outcomes and audience #/description.

Please share an overview of the Learning & Development (training) experience (including audience # and desired outcomes).

If Other, please provide a brief description of the request, including desired outcomes, and audience.

Delivery Format*

In-Person

Virtual

Pre-Recorded

Licensing Content

Please provide the City, State, and Country.

Timeline or Date of Appearance?*

Provide the specific date you are requesting or a date range for when you want to start and end the project.

Are you interested in information on the options to purchase copies of the Waymakers book for the participants/attendees of this event?*

Project Approval & Budget*

This project is ...

Approved Budget $

If not approved, when do you anticipate making a final decision?

Any additional details or comments that will help us best support this request?

How did you hear about us?*

Engagement Requests

Engagement Requests

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