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Let's Connect: Booking Request Form - Speaker Engagement
Thank you for considering me as a speaker for your event! Please fill out the form below to provide me with some information about your event and your speaker needs. I'll be in touch with you soon to discuss the details further.
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Your phone number?
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Your answer
Organization Details:
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Your answer
Name of Event| Date of Event| Time of Event| Location of Event: (Please answer all questions with details needed)
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Your answer
Expected number of attendees
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20-50 attendees
50-100 attendees
100-200 attendees
200-500 attendees
Other:
Event website/social media pages:
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Your answer
Audience Type:
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Educators
Admins
Scholars
Parents
Non-Profit
Other:
Desired Outcome of the Presentation:
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Your answer
Speaking fee or budget and/or travel details:
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Your answer
How did you hear about me?
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Your answer
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