Request Form

Please complete the Request Form as fully as possible and provide the following information in your message:


1. Who is your audience (academic/business)?

2. What is your expected audience size?

3. Type of Organization (Non-Profit or For-Profit)

4. Registration Fee for Attendees?

5. What are your speaker benefits (honorarium/travel expenses/guest allowance)?


For speaking engagements, we appreciate at least three weeks notice for events outside the East Coast or International events

DR. MANSUR HASIB

GLOBAL AWARD WINNING EDUCATION LEADER, AUTHOR, AND KEYNOTE SPEAKER