Please provide a brief description of the event theme or topic you would like Kay Cole to speak on or facilitate a workshop about. *

Name and Address of Venue: *

Is the event taking place in-person or virtually? *

If in-person, please provide any specific room or equipment requirements. *

Start Date and Time:

End Date and Time:

Please provide an estimate of the number of attendees expected at the event. *

Are there any specific equipment or room setup requirements for Kay Cole's presentation or workshop? *

What is your budget for securing Kay Cole as a speaker or workshop facilitator?

First Name *

Last Name *

Phone *

Email *

Preferred Method of Communication (Select all that apply)

Would You Like To Stay In Touch? *

Yes

How Did You Hear About Us?

Message

Thank you for completing this intake questionnaire. Once submitted, our team will review the information provided and follow up with you to discuss further details and confirm Kay Cole's participation in your event.

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