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Speaker Contract Request Form
Please complete this form to receive your contract from Penny Zenker of SmartMoves Coaching LLC.
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Email
*
Your email
Name of Contact
*
Your answer
Phone Number
*
Your answer
Name of Company
*
Your answer
Company Address
*
Your answer
Event Location
*
Your answer
Any special directions/instructions for the event location
Your answer
Topic of Event
*
The Productivity Zone
Own Your Focus
Resilience
Effective Communication
Innovation/Thinking Outside of the Box
Team Building and Collaboration
Other:
Number of Attendees
*
Your answer
Number of Workbooks Desired ($15/each)
Your answer
Workbook Selection
Choose
Accelerate Time Management
Accelerate Resilience
Accelerate Communication
Accelerate Productivity 1:3:5 Daily Planning Journal
Accelerate Productivity Quarterly Planner
None
Date of Event
*
MM
/
DD
/
YYYY
Start Time
If you are unsure of the time, please make an approximation.
Time
:
AM
PM
End Time
Time
:
AM
PM
Duration of Event
If you are uncertain the the start and end time of the event, please provide an estimation of the duration of the event. (EX: 1.5 hours)
Your answer
Budgeted Amount
*
Your answer
Select your payment method below
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Choose
Check
Credit Card
ACH
Other..,
Additional Comments?
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