Speaking Engagement Inquiry Form Topic*Fuse, the Missing Piece of CommunicationFrom Pain to PurposeOutsmart your BrainTurn Leaders into InfluencersParenting ABC'sOtherAudience*ChildrenTeensYoung AdultsAdultsParentsCouplesOffice/ Work spaceRetreatCorporate eventConventionFund RaisingOtherDate of Event* Time of Event*1-HR KEYNOTE SPEECH ($5,000-$15,000)1-HR WORKSHOP/TALK ($2,500)FULL DAY Workshop (6 hours)-($4,500)HALF DAY Workshop (4 hours)-($3,000)FULL DAY 8 Week Program -$28,000 ($8,0000 discount)HALF DAY 8 Week Program-$20,000 ($4,000 discount)Who referred you to Dr. Betsy Guerra?*What concerns or desires are you looking to address with Dr. Betsy’s Presentation?*What would you like your audience to have learned after Betsy’s presentation? How do you want them to feel when they leave?*
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