Antwon Brinson Speaking Questionnaire
Thank you for the opportunity to create a positive impact with words.  In order to abide by the rule "Know Your Audience", I ask that you please fill in this form to give me some insight as to whom I will be speaking to.  

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Email *
Organization
What company/organization do you represent? *
Contact Person
Let's start with your name (first, last) *
Email address *
Phone Number *
Event Information
Date and Time
MM
/
DD
/
YYYY
Date and Time
Time
:
Fashionably Late/Delays
Are participants likely to be on time or will there likely be some delays?
Clear selection
How did you hear about us? *
Location
How can I find the location, and if applicable, is transportation provided?
Topic Of Discussion
I lecture on various topics; which topics would be applicable to this audience? *
Required
Who's in the Audience
Help me understand whom I'm speaking to? *
Required
What size is your audience? *
Format
Clear selection
How much time is needed for your event? *
Equipment
What will be available to me
Clear selection
How many lecturers are before me and after me? What are they speaking about?
Any other considerations
For example, will there be a need for a translator? Has anyone from the audience heard me speak before? Etc.
Budget
What is your approximate budget for my talk? *
Will flights and Accommodations be needed?
Clear selection
Do you have any other areas of Interest? *
What is the end goal for your event? *
Is there anything else you would like to share? *
Submit
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