Speaker Request
AM Horizons Training Group has a number of speakers that will motivate and inspire any group you are working with.
First Name *
Your answer
Last Name *
Your answer
Organization's Name *
Your answer
Email *
Your answer
Phone *
Your answer
Address 1 *
Your answer
Zipcode
Your answer
City *
Your answer
State *
Your answer
Preferred Contact Method *
Speaker/Facilitator *
Type of Company or Organization *
Select your orgizational type
Services *
Select services you would like information about
Required
Certifications
Will this course be used for Continuing Education Credits?
Service Delivery *
Select the service delivery method
Required
Purpose of Appearance: (choose)
Audience Demographics *
Select your type of group
Required
Goal #1 for this session *
Please share what your outcames are for this session
Your answer
Goal #2 for this session *
Please share what your outcames are for this session
Your answer
Goal #3 for this session *
Please share what your outcames are for this session
Your answer
Date of Training *
Your answer
Start time: *
Your answer
End time: *
Your answer
Address of Location for Training Event: *
Your answer
Presenter Budget *
Please Specify Budget Range
Scholarship Request Form *
What percent of our fees would you like us to contribute. Our mission drives our efforts.
Your answer
Venue Type: (Hotel/Convention Center/Church etc.)
Your answer
Room Configuration *
Please give us information about the room
Audio/Visual Equipment Available *
Audio/Visual Equipment That You Can Provide
Required
Your answer
How did you hear about us? *
Required
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