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Request Speaking Engagement
Please give me a little information to help me know you. There’s also a space for preliminary questions you might have. I'll get back to you as soon as possible. It won’t be long!
Name
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First
Last
Email
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Phone Number
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Description of Event
First Choice of Date
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MM
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DD
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YYYY
Second Choice of Date
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MM
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DD
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YYYY
Location
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City, State, Zip
What type of venue is this? Could you please describe the setting and location of where you would like me to come and speak (type of audience, etc.)?
*
If you have had this event in the past, please include a few names of past speakers:
Speakers you have had in last few years
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Number of women attending in last few years
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Other Details/Questions:
Anything else you would like me to know:
What preliminary questions do you have for me?
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