The Empowerment Speakers of 4 Real Women International Inc. have experience presenting in a variety of settings (corporate events, professional conferences, radio and TV talk shows, forums, church, and religious gatherings). To provide you with the best service possible we invite you to take the time to complete and submit this form at least 45 days prior to your event date.

Name of hosting organization*

Name of contact person for organization:*

E-mail of contact person:*


Place and address of workshop presentation:*

Date and Time of presentation:*

Type of presentation:*
Keynote address (15 - 30 minutes)Homily (40-50 minutes)Member of a panel or forumRadio or TV talkshow/interview

What specific topic would you like our speaker to address?*

What additional information would you like us to know about your group, organization or event?:*

Please state any additional comments here:

Where did you find out about 4RWI Empowerment Services:*
By recommendationOur organization has been serviced by 4RWI in the pastWe Have attended a 4RWI Program (LEAD!, VoW etc.)Online or at 4RWI websiteOn Facebook, twitter, Linked In, Tumblr, Instragram, PinterestOther.

If you chose other above, pleas specify:*

Terms of services:
A non-refundable booking fee of US $150, which serves as a down payment for services, is required to secure services of 4RWI Speakers.
For events and activities outside of the Tri-state area (NY,NJ,CT) organizers will need to consider overnight lodging and meals for the speaker.
All booking fees should be paid in advance at least one week before date of event.
Once you complete and submit this form a 4RWI Inc. representative will initiate contact about your request via e-mail or telephone.

Please type your name as proof that you have read and understand the terms of services stated above:*