Program Information Form

Once you've booked Laila for your event, complete this form. 

 

Please complete the form below

Event Contact *
Event Contact
Date(s) of Presentation *
Date(s) of Presentation
Presentation Start Time *
Presentation Start Time
Presentation End Time
Presentation End Time
Any sort of demographic information that will help tailor the message.
Microphone Available? *
Classroom style, round tables, theatre, etc.
If yes, when do you need the title/description by? *
If yes, when do you need the title/description by?
On-Site Contact Name *
On-Site Contact Name
On-Site Contact Mobile Number *
On-Site Contact Mobile Number
GPS location, building name, room number, etc.
 

Billing Details

Please complete to confirm billing details are correct. 

Billing Contact Name *
Billing Contact Name
Phone
Phone
$
$
$
Google, referred by someone, Laila reached out directly, etc.