Tell us about your organization and the overall event so we understand the context, audience, and vision.

Event Organizer Name *

Event Organizer Entity Type *
—Please choose an option—For-profit company or organizationNonprofit organizationIndividualChurchSchool/UniversityOther

If “Other”, please describe

Organizer Website and/or Social Links

Event Website

Event Title *

Event purpose, vision, or mission *

Describe the attendee demographic *

Full event date(s) *

Event venue *

Share how you would like Dr. Glenn to serve at your event, including format, timing, and key themes.

Requested speaking date *

Session type *
—Please choose an option—Keynote SpeakerMain Stage SpeakerBreakout SessionPanelInterviewNetworking EventTraining SessionOther

If “Other”, please describe

Appearance Type *
—Please choose an option—In-PersonVirtualHybridOther

Topic(s) requested *

Additional requests (check all that apply):

Pre-event interview (e.g., IG Live session)Event promotion (posting/reposting)Ticket salesSwag bag itemWritten materialsVideo clipsOther

If you checked any boxes above, add details *

Will the speaking be recorded? *
—Please choose an option—YesNoOther

If recorded, do you intend to repurpose the recording?
—Please choose an option—YesNoMaybeNot applicableOther

Let us know who our team should follow up with regarding logistics, contracts, and next steps.

Phone number *

Honorarium amounts reflect time, expertise, preparation, and impact. Travel and lodging, when applicable, are separate from the honorarium.

Your budgeted honorarium amount *

I confirm the details provided are accurate to the best of my knowledge.