Contact name: (required)
Contact email: (required)
Event website / company website:
What is the name of the event?
Where is the event being held? (Leave this blank if the location has not yet been set.)
State / Province / Region
Postal / Zip Code
Proposed date of the event:
Duration of Liz's talk (ie: 30 Minutes, 60 Minutes):
How many attendees are expected?
Will there be an opportunity to sell books / other products at the event?
Will travel expenses (if required) be covered by the event?
Why do you think Liz would be a good fit as a speaker for your event?
Is there anything else we should know?