Bernadine Speaking Engagement Form
This is a request form to have Bernadine speak at your next event. Please presume travel + lodging expenses with your speaking budget.
E-mail Address: *
Your answer
Name (first and last): *
Your answer
Organization: *
Your answer
Website: *
Your answer
Date of Event: *
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Time of Event: *
Time
:
Location of Event: *
Your answer
Expected Number of Attendees: *
Your answer
Type of Speaking Engagement(s): *
Required
Length of Speaking Engagement: *
Your answer
Speaking Topic(s): *
Your answer
Speaker Budget: *
Your answer
Room Type: *
Required
Additional Information: *
Your answer
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