Alicia's Speaking Inquiry Form
We're so excited you're interested in having Alicia speak in your area. Please share some information with us about your event.
First Name
Your answer
Last Name
Your answer
Your role within the event or relationship to the organization
Your answer
Email Address
Your answer
Preferred Contact Number
Your answer
How did you hear about Alicia?
Your answer
About the Event
Sponsoring organization
Your answer
Sponsoring organization's website
Your answer
Event Name
Your answer
Event begin date
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DD
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YYYY
Event ending date
MM
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DD
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YYYY
Number of times you are requesting Alicia to speak
Your answer
Event website (if any)
Your answer
Event venue name
Your answer
Event venue address
Your answer
Airport Alicia should fly into
Your answer
Past attendance
Your answer
Anticipated attendance
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Description of participants
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Past speakers
Your answer
Why would you like Alicia to speak at this event?
Your answer
Is there a particular theme you would like Alicia to address?
Your answer
For budgeting purposes, please indicate your budgeted speaking honorarium (and please know that Alicia does not accept or decline invitations based on finances).
Your answer
Can Alicia's resources be available for purchase at the event?
Are you able/willing to provide airfare for Alicia and her assistant?
Are you able/willing to provide accommodations for Alicia and her assistant?
Please feel free to include any other information that might be of interest concerning the nature and purpose of this event.
Your answer
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