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Speaking Interest Form
Thank you for your interest in booking me as a speaker. Please provide as much information on the form as possible and I will be in touch to set up our next steps!
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Email
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Your email
Name
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Email Address
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Phone Number
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Organization/Company/Campus
Your answer
Date of Speaking Engagement
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Is this an in person or virtual event?
In Person
Virtual
Both
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Please provide a short description of your event.
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How did you hear about me? (I love thanking those who refer me!)
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Send me a copy of my responses.
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