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Speaking Requests
speaking request for GBarron Consulting
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Email
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Your email
Primary Contact First/Last Name
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Your answer
Email
*
Your answer
Website
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Your answer
Phone Number
*
Your answer
Is this "primary" contact the same as the "day of" the event contact
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Yes
No
Other:
Event Details
Select the of Organization
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Non-Profit organization
Church
School
For-Profit business
State Agency or Association
Name of the Event
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Your answer
Event Start Time
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Time
:
AM
PM
Event End Time
*
Time
:
AM
PM
Name of Venue
*
Your answer
Venue Address
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Your answer
City
*
Your answer
State
*
Your answer
Zip Code
*
Your answer
Presentation Topic
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Your answer
Number of Participants
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Your answer
Age of Participants
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Elementary School
Middle School
High School
College/Young Adults
Adults
Speaker Request
Budget for Speaker
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Your answer
Time of Speaking Engagement
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Time
:
AM
PM
Length of Time for Speaking Engagement
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Your answer
Desired Services
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Choose
Keynote
Workshop
Professional development and training
Business and nonprofit consultation
Program Implementation and Design
Other
Information Requested from Gretchen
Speaker Bio
Headshot
Invoice/W-9
Flight Itinerary
Will a product table be available?
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Yes
No
Please provide any additional information for your request/
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Your answer
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