Sanctuary Night Speaker Request Form

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Sanctuary Night not only creates a sacred space for vulnerable womxn, we also like to bring awareness to new communities of folx. It would be our privilege to share some of our experience & awareness with you. Speaker fees will vary. Please fill the form out below and a Sanctuary Night team member will be in touch soon!

Email *

First & Last Name *

Email Address *

Phone Number *

Event Name & Location *

Date of event *

YYYY

Time of event *

Time

Other Event Details. (number of audience members, who the audience is, time frame for speaker, and any other important details)
*

Type of Speaker Being Requested *

Lived Experience (story telling of personal experiences)

Training/Awareness

Panel of Speakers with Moderator

Sanctuary Night info

Other:

Number of Speakers Being Requested *

3-5

Other:

How are you hoping your event will be impacted by a speaker from Sanctuary Night? *

Send me a copy of my responses.

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