Speaker Request Form for Suzan' Stroud
Thank you for your interest to have me come in and speak to your team.  In an effort to best fulfill your request and the needs of your organization, please complete the below information. Travel (Ground or Air) and Hotel Accommodations should be included in your budget.  You will receive a response within 48 hours to scheduled a time to further discuss event details.  
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Email *
Company/Organization Name  *
Company/Organization Address *
Company/Organization Website *
Contact Person First and Last Name *
Contact Person Best Phone Number *
Contact Person Best Email Address *
Event/Meeting Date *
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DD
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Event/Meeting Theme *
Event/Meeting City and State Location *
Event/Meeting Hosting Location *
Event/Meeting Time"  *
Time
:
How many attendees are you expecting? *
Have you previously hosted this event or meeting in the past? *
If "Yes", how many were in attendance?
Type of Platform *
Allotted Time for Speaker *
Will there be a Q&A segment? *
Speaker Budget *
Additional Details *
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