Tatum Temia Speaker Request
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First Name
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Last Name
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Email
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Phone
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Organization Type
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Church
Non-profit: Non religious
College/University
Corporate
Other
Company
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Company Website
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Venue Address
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Venue City
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Venue State
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Venue Zip
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Event Date
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Event time
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Time
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AM
PM
Is your date firm?
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Name of Venue
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Details and Purpose of Event
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Estimated Attendee Numbers
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Under 50
50-100
100-300
300-500
500+
1000+
Event Attendee Demographic
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Will this event be open to the public?
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Will tickets be sold for this event?
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Yes
No
Do you intent to record or livestream this event?
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Yes
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Can products be sold at this event?
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Yes
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