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Blazing Brains Live Events Interest Survey
This survey pertains to live speaking events offered by Amy Tyler, ND of Blazing Brains on the Topic of Nutrition for Healthy Brains: How Food Affects Mood, Focus, & Energy. Once you've completed this interest survey, we will reach out to schedule a time to discuss in more detail. Please email support@blazingbrainskids.com with any questions or if you experience difficulties with this form. Thank you! 
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Your name: *
Phone number: *
Email address: *
Name of your organization or group? *
Which topic/audience is the right fit for your group? *
Are you interested in a live or virtual event? *
Which presentation duration do you prefer? *
Which topics most interest your group? *
Required
Please fill in any additional information or questions you'd like to discuss here (optional). We'll be in touch shortly! 

Math Captcha: Please fill in the correct answer to this math problem (to deter spam/bots from using this form):
33 + 44 = 


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