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.
Email
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
High Performance
Diversity/Equity/Inclusion/Belonging
Ethics in Leadership
Program Development
Culturally Competent Supervision & Mentorship
Mental Health and Well-being
Other
If you selected 'Other', please describe below
Format Request
Webinar
Keynote
Half-Day Workshop (up to 4 hours)
Full - Day Workshop (beyond 4 hours)
Other
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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