Embracing My Natural, Inc. Event Interest Form
Please complete this form if you are interested in Embracing My Natural, Inc. facilitating an event for your organization, business, school, etc. We are open to event ideas!

Learn more about our past events at www.embracingmynatural.org
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Email *
Today's date *
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Please provide a person of contact (first and last name): *
What is the name of your organization, business, school, etc.?
 *
Where are you located? *
Do you classify as a public, private, charter school, college or university?
 *
Do you classify as a non-profit organization? *
Do you classify as a minority-serving organization, business, school, etc.? *
What is your website and/or social media information? *
How would you like your event delivered? *
Required
Where will the event be located? *
What is the proposed event date? *
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What is the proposed event time? *
Time
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What is the length of your proposed event? How long do we have to complete our portion of the event? *
What is your projected audience size and composition? *
Will there be access to media (microphone, podium, laptop for presentation, internet, etc.)? *
Would you like to include products for the event as a part of your package? If so, what products? *
Required
Do you have a budget for this event? If so, what is your proposed budget for this event (speaker budget)? *
What date would you like a speaker confirmation? *
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Please provide any other helpful information about your event. Include event ideas. All ideas are welcomed!
A copy of your responses will be emailed to the address you provided.
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