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Angela's Speaking Questionnaire
Thank you for the invitation to speak. I ask that you please fill in this form to give me some insight as to whom I will be speaking to. Thank you!
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Email
*
Your email
Your first & last name
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Your answer
Name of your organization:
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Your answer
Describe the event in a few words:
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Your answer
The sponsor / host of the event is:
*
Your answer
Your Website
Your answer
Cell phone #
*
Your answer
Date(s) and Time(s)
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Your answer
Location
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Your answer
Time Allotment
*
Your answer
Who's in the Audience?
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Your answer
How did you hear about Dr. Angela?
*
Your answer
Anything else you'd like to add?
Your answer
Anything else you'd like to add?
Your answer
A copy of your responses will be emailed to the address you provided.
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