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Speaking Request Form
Thank you for your interest in requesting a Stability Leader speaker from The Stability Network. We will review your request and should get back to you within two weeks of your request. Thank you for your patience.
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Email
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Your email
Name
*
Your answer
Organization, Company, or Group you would like to bring the speaker to
*
Your answer
In what city will this speaking engagement take place?
*
Your answer
Are you willing to provide travel reimbursement for the speaker(s) (if applicable)?
*
Your answer
What potential date are you requesting a speaker for?
MM
/
DD
/
YYYY
What type of event is this?
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Your answer
Which format are you looking to plan?
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Single speaker
Panel - I would like 2 - 3 Stability Leaders
Panel - I would like 1 Stability Leader to participate
Not sure
Are there any specific qualifications you are looking for in a speaker (specific background, etc.)?
*
Your answer
Is there any specific key message(s) that you want the audience to take away?
Your answer
Is there anything else you feel is important to share?
Your answer
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