Speaker Request - Bennie F. Johnson
Thank you for your interest in AMA CEO, Bennie F. Johnson for your upcoming event. Please complete this short form with details about your event to help the AMA Office of the CEO process your request. 
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Event Name *
Event Date
Event Location
Event Theme/Topic
Requested Speaking Topic
Requested Speaking Format (select all that apply)
Requested Speaking Length 
Expected Audience Size
General Audience Composition
Reason for selecting Bennie as a speaker
Contact Person/Event Organizer Name
Contact Person/Event Organizer Email
Contact Person/Event Organizer Phone Number
Any additional Information/Specific Requirements for the Presentation?
Confirmation Deadline
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Is there a speaker budget for your event?
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Additional Comments/Questions
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