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Ustadah Ariba Farheen Speaker Request Form
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* Indicates required question
Email
*
Your email
Hosting Organization:
*
Your answer
Organization Representative:
*
Your answer
Event Format
*
In-Person
Online
Pre-recorded
Recommended Date of Event:
Please ensure the "Date" is in the Sydney Time zone.
MM
/
DD
/
YYYY
Time of Event:
Please ensure the "time" is in the Sydney Time zone with AM/PM.
Time
:
AM
PM
Is your date flexible?
Yes
No
Maybe
Clear selection
How long are you requesting Ustadah Ariba to speak for, including Q/A and discussion?
15 minutes
30 minutes
1 hour
1.5 hours
Other:
Clear selection
How many people are you expecting to be in attendance?
*
Your answer
What topic would you like Ustadah Ariba to speak on? Please be as specific as possible.
If you have listed multiple topics, please outline your number one topic of choice.
*
Your answer
Website URL
Your answer
Social Media URLs
Your answer
Which option best describes your organization:
*
University or College
Masjid (Mosque)
Non-Profit Organization
Other:
Thank you for inviting Ustadah Ariba Farheen to speak. Please allow one week for a response.
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