Your Name (required)

Your Email (required)

Your primary phone number (optional):

Date (or dates) for which you are requesting Sonali:

Is this request for Sonali to Em-cee, moderate, or speak at an event?SpeakerEm-ceeModerator

If this is a request for her to speak, will she be on a panel with other speakers or speak by herself? —Please choose an option—Panel with othersSpeak by herself

Location of event:

If this event is outside the Los Angeles area, will you be arranging for transportation for Sonali?

Event is local to Los AngelesYes, we will provide a carYes, we will reimburse gas expensesYes, we will provide only airfareYes, we will provide only airfare and a hotel roomYes, we will provide airfare, hotel room, and mealsEvent is outside LA but we cannot provide any transportationOther (explain below)

Other:

If this event is in the Los Angeles area, Will you be arranging for parking for Sonali?

—Please choose an option—YesNo

How many people do you expect will attend?

What honorarium/speaking fee can you offer?

Is this part of a speaker series, conference, class, or a special one-time event? (required)

Speaker seriesConferenceClassroom lectureSpecial one-time invitationOther (explain below)

Other:

Does the location have audio/visual capabilities?

YesNoNot Sure

Please explain how you plan to advertise this event:

Explain briefly the topic you would like Sonali to address

Please add any extra requests below if needed:

Thank you! Someone will contact you shortly with a response to your request.

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