Shafia Monroe Birthing Change

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Speaker Request Form

SMC Speaker Request Form

Thank you for your interest in booking Motivational Speaker Shafia M. Monroe. In order to help us facilitate your request, please complete and submit the following form (and any corresponding attachments) to assistant@shafiamonroe.com at least 2 weeks prior to the event and allow 3-5 business days for decisions to be made.

Part 1: Event Organizer

If you have any questions or need help completing the Speaker Request Form, please contact Kamaria Wilson, Accounts Coordinator at 503-281-1688.
Name of Coordinator/Point of Contact(Required)

Part 2: Event Details

Event Location(Required)
MM slash DD slash YYYY
Event Time(Required)
:

Part 3: Presentation/Speech Details

What would you like Shafia to speak about at your event?

Part 4: Audience Details

Part 5: Additional Information

MM slash DD slash YYYY

Please submit speaking requests at least 2 weeks prior to the event and allow 3 – 5 business days for a decision to be made.

If you have any questions or need help completing the Speaker Request Form, please contact Kamaria Wilson, Accounts Coordinator at 503-281-1688. This completed form will be submitted to assistant@shafiamonroe.com.