ZingPop Social Media: Event Questionnaire
RequiredRequired Question(s)
Thank you for your interest in having me speak at your event! Please note that your request is not confirmed until you receive a confirmation email from me.
I want to provide you with the best event experience as possible, so please take a moment to answer the following quick questions:
Required 1.

On what topic would you like me to present?


50 characters left.
Required 2.
Approximately how many people will be attending?

50 characters left.
Required 3.
Is this a public or private event?

  • Comment:

  • 500 characters left.
Required 4.

Date of Event:


50 characters left.
Required 5.

Time of Event:


50 characters left.
Required 6.

Parking Details (paid lot, street, public lot, etc):


50 characters left.
Required 7.
What AV will be included at your event (ie: projector, screen, TV, etc):

350 characters left.
Required 8.
Will you share the list of attendees with me?**
**I do require a list of the attendees that must include first name, last name, email address, phone number, and business name. Please note: I do not call anyone nor do I add them to my general mailing list; I send an email with a PDF copy of the presentation within 2 business days of the event.
  • Comment:

  • 500 characters left.
Required 9.
Please enter the event contact and event location information indicated below.

First Name:
Last Name:
Company Name:
Work Phone:
Email Address:
Address 1:
Address 2:
Postal Code:


Any further comments?


350 characters left.
Thank you for taking the time to provide me with this information. I will be contacting you shortly!