Speaking Engagement Request Form

Book a Conference / Workshop with Karla Ruiz Cofiño.

Please completely fill out the form below, and a representative will contact you shortly.

Question Title

1. Who is the primary contact person? (Required.)

Name: *

Company:

Country:

Email Address: *

Whatsapp Number:

Question Title

2. About the Event / Engagement : (Required.)

Name:

Country / City:

Time zone:

Venue or Digital Platform:

Is the event for Profit or Nonprofit:

What is the purpose of the event:

Who else is speaking and on what topics:

Question Title

3. Event Format (Required.)

In Person

Online

Hybrid

Question Title

4. Event / Engagement DATE, START and END TIME: (Required.)

Date / Start Time

Date

Time

AM/PM

Date / End Time

Date

Time

AM/PM

Question Title

5. Exact number of hours the speaker is expected to be in attendance, including early arrival or login, Q&A, and participation in any pre-event or post-event meetings and discussions: (Required.)

Question Title

6. Will this event be streamed live, recorded, or shared on Social Media? (Required.)

Streamed live for a private audience

Recorded to be shared with a private audience

Streamed live in Social Media

Recorded and shared on Social Media

Would you like to share the PDF of the presentation with the participants?

Other (please specify)

Question Title

7. Please share some details on the participants: (Required.)

Number of attendees expected:

Age range:

Demographics (i.e. profession/knowledge level):

Any other useful info to serve them best:

Question Title

8. Proposed Presentation & Speaker fee: (Required.)

Question Title

9. Additional information: (Required.)

Question Title

10. Which topic are you interested in: (Required.)

Digital Awareness for Parents > What is Digital Intelligence and why it is so Important?

Digital Awareness for Parents > Digital Citizenship is the new Citizenship

Digital Awareness for Parents > Digital Well-being: Disconnect to Reconnect

Digital Awareness for Parents > Fake News and Misinformation: Learning to Critically Evaluate Media Sources.

Digital Awareness for Parents > Online Parental Control Tools

Digital Awareness for Leadership > From Digital User to Digital Leader

Digital Awareness for Leadership > Personal Brand and Digital Tattoo

Digital Awareness for Leadership > Building Social Capital & Meaningful Online Communities

Digital Awareness for Business > Digital Strategies for Positive Impact

Digital Awareness for Business > Digital Marketing Trends

Digital Awareness for Business > Telemedicine and Digital Health

Motivational Talk > 40 Years, 10 Life Lessons

Motivational Talk > Activating my Positive Energy: The Power of the Happy Chemicals

Custom Made Conference / Workshop

Participation on a Forum or Panel

Other (please specify)

Speaking Engagement Request Form

Book a Conference / Workshop with Karla Ruiz Cofiño.

Question Title

* 1. Who is the primary contact person? (Required.)

Question Title

* 2. About the Event / Engagement : (Required.)

Question Title

* 3. Event Format (Required.)

Question Title

* 4. Event / Engagement DATE, START and END TIME: (Required.)

Question Title

* 5. Exact number of hours the speaker is expected to be in attendance, including early arrival or login, Q&A, and participation in any pre-event or post-event meetings and discussions: (Required.)

Question Title

* 6. Will this event be streamed live, recorded, or shared on Social Media? (Required.)

Question Title

* 7. Please share some details on the participants: (Required.)

Question Title

* 8. Proposed Presentation & Speaker fee: (Required.)

Question Title

* 9. Additional information: (Required.)

Question Title

* 10. Which topic are you interested in: (Required.)

1. Who is the primary contact person? (Required.)

2. About the Event / Engagement : (Required.)

3. Event Format (Required.)

4. Event / Engagement DATE, START and END TIME: (Required.)

5. Exact number of hours the speaker is expected to be in attendance, including early arrival or login, Q&A, and participation in any pre-event or post-event meetings and discussions: (Required.)

6. Will this event be streamed live, recorded, or shared on Social Media? (Required.)

7. Please share some details on the participants: (Required.)

8. Proposed Presentation & Speaker fee: (Required.)

9. Additional information: (Required.)

10. Which topic are you interested in: (Required.)