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Nicole R. Coleman Speaker Request Form
This is a request to have Nicole speak at your next onsite or virtual event. Please assume travel + lodging expense with your speaker budget.
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Name (First and Last):
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Your answer
Email Address:
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Your answer
Organization:
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Your answer
Website:
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Your answer
Date of Event:
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MM
/
DD
/
YYYY
Location of Event:
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Your answer
Time of Event:
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Your answer
Expected Number of Attendees:
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Your answer
Description of Type of Talk:
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Keynote
Panel
Training/Workshop
Other
Length of Talk:
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Your answer
Speaking Topic:
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Your answer
Speaker Budget:
*
Your answer
Additional Details:
Your answer
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