Booking Requests

Thank you for your interest in having Dr. Dispenza speak at your event. In order to give you an accurate fee quote, please fill out the questions below.



Contact Name (required)

Company Name (required)

Website

Phone

Fax

Your Email (required)

Confirm Email (required)

City

State

Zipcode / Postal Code

Country

How did you hear about us? / Referred by..


EVENT DETAILS

Subject

Dates

Locations

Objectives / Comments /Questions


Do you have an honorarium that you usually pay for speaker?

Where will the event be located?

Who is the audience? Professionals, public or both?

How many will be in the attendance?

Are you looking for a lecture or a workshop?

What would you charge for ticket prices?

What type of publicity do you do?

Do you have an elist? If so, how large is it?
If your event requires translation, list the language being translated to.

Please note, that if translation is required it MUST be Simultaneous Translation

Have you ever run an event like this before?

If so, then please list the last three events you have done?






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