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BSA Speaker Inquiry
If you are interested in having one or more of our speakers participate in your speaking engagement, please fill out the following information:
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Email
*
Your email
Full Name (First, Middle, Last)
*
Your answer
Best e-mail for our team to be able to reach you:
*
Your answer
Names of speaker(s) you're Interested in:
Your answer
Booking codes for speaker(s) you are Interested in:
*Note, some speakers may not have a booking code, in this case, this section can be left blank.
Your answer
Date/Month of event:
MM
/
DD
/
YYYY
Address/City/State of event location:
*
Your answer
Best phone number (s) to reach you:
Your answer
Estimated Budget
Your answer
Topics relating to this event (i.e. Leadership, Communication, Management, Networking, etc.)
Your answer
Please describe the type of event (i.e. Educational Training, Keynote Address, Graduation, etc.)
Your answer
Will you have any guests in attendance with special needs? (i.e. hearing, vision, mobility, etc.)
Your answer
Will food be served at the event?
Yes
No
Other:
How many people are expected to be in attendance at your event?
Your answer
Please list your availability below or schedule a meeting by clicking on the link to arrange a time to discuss your event here:
https://calendly.com/cstein2011
Your answer
A copy of your responses will be emailed to the address you provided.
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