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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.
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* Indicates required question
Email
*
Your email
Contact Information
First Name
*
Your answer
Last Name
*
Your answer
Your Role
*
Your answer
Email Address
*
Your answer
Preferred Contact Number
*
Your answer
How did you hear about Alicia?
Your answer
About the Event
What type of event is this?
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Retreat
Church Service
Conference
Podcast
Radio Interview
TV Interview
Online Interview
Other:
Sponsoring organization
*
Your answer
Sponsoring organization's website
*
Your answer
Event Name
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Your answer
Event begin date and time
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MM
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DD
/
YYYY
Time
:
AM
PM
Event ending date and time
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MM
/
DD
/
YYYY
Time
:
AM
PM
Number of times you are requesting Alicia to speak (please indicate the scheduled times of each, if available).
*
Your answer
How long would you like Alicia's talk to be?
*
Your answer
Event website (if any)
Your answer
Event venue name
*
Your answer
Event venue address
Your answer
Recommended Airport
Your answer
To aid in the booking of Alicia's tickets, what is the distance and typical travel time on any given day between the airport and event venue?
Your answer
Past attendance
Your answer
Anticipated Attendance/Reach
*
Your answer
Description of Participants/Target Audience
Your answer
Past speakers
Your answer
Why would you like Alicia to speak?
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?
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Yes
No
Are you able/willing to provide airfare for Alicia and her assistant?
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Yes, for Alicia only.
Yes, for both.
No.
Are you able/willing to provide accommodations for Alicia and her assistant?
*
Yes, for Alicia.
Yes, for both.
No.
If you have a deadline by which you need to hear from Alicia's speaking board, please provide a date.
MM
/
DD
/
YYYY
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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