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Speaker Request Form
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Hi! What's your name?
Your answer
What's the name of your organization?
Your answer
What is your website & social media handles?
Your answer
I'm interested in booking Caitlan for: (choose as many as you would like)
In-person Event
Online Event
Podcast
Retreat
Other:
What role would you like Caitlan to have at your event?
Appear and contribute to a panel discussion (Panel Appearance)
Moderate a panel (Panel Moderator)
Speak on Specific Content (Speaker- Q & A Style)
Create and teach a workshop on specific content (Speaker-Workshop Facilitation)
Other:
Clear selection
When is your event?
MM
/
DD
/
YYYY
What is the location of the event?
Your answer
Time
Time
:
AM
PM
Duration of the entire event
Your answer
Expected number of attendees (How many folx do you expect this event to impact?)
Your answer
Purpose/goal/ objective of the event? What do you want your attendees to walk away with?
Your answer
What about Caitlan and the work she does/her message aligns with your organization and/or audience?
Your answer
For Podcasts, IG LIVE and Q & A style events only: What are 3-5 questions you'd like to discuss with Caitlan? [We understand due to the conversational nature of podcast interviews, you may not touch all of these].
Your answer
What is your budget for the event?
Your answer
Any additional information you'd like to share?
Your answer
How did you hear about Caitlan?
Your answer
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