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Speaking Request Form
For Ron L.
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Email
*
Your email
Your Name
*
Your answer
Your Phone
*
Your answer
What is your company/organization name and website?
*
Your answer
What is the name of the event?
*
Your answer
What is the date of the event?
*
MM
/
DD
/
YYYY
What time does the event begin?
*
Time
:
AM
PM
Would you like have Reggie Raccoon Live
*
No
Yes
What address will the event take place?
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Your answer
How many guest do you anticipate on being there?
*
Your answer
What is the purpose of your event?
*
In Person Reading/Motivation Talk
Online Reading/Motivation Talk
Would you like to order books?
*
Yes
No
How did you discover Ron L.
*
Your answer
Send me a copy of my responses.
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