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Booking Request Form
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* Indicates required question
Name of Organization:
*
Your answer
Requester Name:
*
Your answer
Requester Email Address:
*
Your answer
Requester Contact Number:
Your answer
Are you the event organizer or contact person?
*
Yes
No
Type of Event
*
Workshop
Training
Keynote Address
Guest Speaker
Panelist
Other:
Event Duration (please indicate the length of time for the event ex. 60 minutes, 90 minutes, half day, full day, etc.)
*
Your answer
Theme of the Event/Topic of Discussion
*
Your answer
Preferred/Suggested Date(s)/Time
*
Your answer
Event Location
*
In-Person (please specify location of the event below in the other section)
Virtual (please specify the preferred virtual platform in the other section)
Other:
Required
Anticipated number of attendees
Your answer
Please describe what you hope to achieve during our time together.
*
Your answer
What is your speaker/trainer budget for this event?
*
Your answer
If this is an in-person event, which of the following accommodations can you facilitate, if the invitation is accepted? (Select all that apply)
*
Travel
Hotel
Transportation
Food and beverage
Other:
Required
How did you hear about us? (Select all that apply)
*
Website
Referral
Social Media
Other:
Required
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