Request To Have Ely Speak:

Would you like Ely to speak at your next event? Please completely fill out the form below providing as much information as possible, then click the “submit” button to send us your request. We will contact you right away to discuss your event and whether or there is space on our calendar. For your convenience, you may also contact us via phone at 1-888-681-5559. We look forward to working with you to make your event amazing!

    First/Last Name*
    Company/Association*
    Title/Position
    What is your role in the event?*
    Email Address*
    Phone Number*
    Event Date*

    Month
    -
    Day
    -
    Year
    Event Timeline*
    Start Time, Time Allowed, End Time, Required Breaks, etc
    Event Location*
    Number Expected To Attend
    Event Audience
    (Industry, Business Owners, Entrepreneurs, Sales people, etc)
    Purpose of meeting/event
    Desired Topic of Presentation*
    Additional Comments/Information