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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.
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1.
Who is the primary contact person?
(Required.)
Name:
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Company:
Country:
Email Address:
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Whatsapp Number:
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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:
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3.
Event Format
(Required.)
In Person
Online
Hybrid
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4.
Event / Engagement DATE, START and END TIME:
(Required.)
Date / Start Time
Date
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Date / End Time
Date
January
February
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1900
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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.)
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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)
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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:
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8.
Proposed Presentation & Speaker fee:
(Required.)
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9.
Additional information:
(Required.)
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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)