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.
Contact Information
First Name *
Your answer
Last Name *
Your answer
Your Role *
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Email Address *
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Preferred Contact Number *
Your answer
How did you hear about Alicia?
Your answer
About the Event
What type of event is this? *
Sponsoring organization *
Your answer
Sponsoring organization's website *
Your answer
Event Name *
Your answer
Event begin date *
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Event ending date *
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Number of times you are requesting Alicia to speak *
Your answer
How long would you like Alicia's talk to be? *
Your answer
Event website (if any)
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Event venue name *
Your answer
Event venue address
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Recommended Airport
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Past attendance
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Anticipated Attendance/Reach *
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Description of Participants/Target Audience
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Past speakers
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Why would you like Alicia to speak?
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Is there a particular theme you would like Alicia to address?
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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? *
If you have a deadline by which you need to hear from Alicia's speaking board, please provide a date.
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Please feel free to include any other information that might be of interest concerning the nature and purpose of this event.
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