First Name *

Last Name *

Email *

Business Name *

Event Type *

If other, please specify: *

Event Location *

For in-person events, please state the address below.

Street Address

City

Country

Audience Level *

What is the goal of having Billie speak at your event? *

What outcome would you like the audience to walk away with? *

Are there specific themes or conversations you would like Billie to address? *

Have you attended a previous talk, session, or engaged with Billie's work before? *

Yes

Is this a paid speaking engagement? *

Yes

If yes, please share your proposed speaker budget range *

If no, please provide additional context *

Anything else you feel is important for consideration *