Germanee Gerald Speaker Form
Email Address *
Your answer
Name (First and Last) *
Your answer
Organization & Website ( if applicable) *
Your answer
Event Name *
Your answer
Event Description *
Your answer
Event Date *
MM
/
DD
/
YYYY
Event Time *
Time
:
Event Venue Location *
Please include city and state if this is outside of Los Angeles, California
Your answer
If out of town, will your organization cover travel and lodging expenses?
Speaker Budget *
Your answer
What Type of Talk?
Speaking Topic
Your answer
Expected Talk Length *
Will I be speaking for 15mins, 30 mins, an hour?
Your answer
Will the event be professionally recorded? *
Will the event be professionally photographed? *
Additional Details
Your answer
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