Book Dr. Marcia Levi for Your Event

Thank you for your interest in inviting Dr. Marcia Levi to speak at your event. Please complete the form below so our team can review your request and follow up with next steps. We look forward to learning more about your organization and how we can serve your audience.

Organization

Contact Person's First Name *

Contact Person's Last Name *

Email *

Phone *

Website

Name of Event *

Kindly share a brief description of your event, including its main goals and what you hope attendees or viewers will gain from the experience. *

Event Format (How your attendees are showing up) *

In-Person

Virtual

Hybrid

Is this event public or private?

Public (open to all)

Private (invite only)

Event Date *

Event Address (if in-person)

Event Start and End Time *

What time would you like Dr. Levi to speak?

Expected Audience Size *

Who is your expected audience (community, faith-based, corporate, youth, women’s health, etc.) *

Do you already have a specific topic you would like Dr. Levi to focus on? *

Is this a panel discussion? If so, please provide the anticipated number of panelists, their focus areas, and the name of the moderator.

Is the event free or ticketed/paid? *

Free to the public

Internal/Private access only

Paid

Undecided

Will the event be professionally photographed and video recorded? *

Videography

Photography

We can share footage

We can share photos

Can Dr. Levi bring her own media team? *

Videography

Photography

No

Yes, and we would appreciate you sharing some of what you capture.

Are you offering any of the following for this appearance? *

Free (no payment)

Honorarium

Request for Dr. Levi's full speaking fee

Not sure

Additional information or notes you would like to share with us:

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