Mecca K. Terry - Speaker Request Form
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Email *
Please provide a person of contact (first and last name): *
What is your website and/or social media information? *
Do you classify as a non-profit organization? *
Do you classify as a public, private, charter school, college or university? *
What are the proposed event details (topic, description, etc.)?: *
How would you like your event delivered? *
Required
What is the proposed event date? *
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What is the proposed event time? *
Time
:
What is the length of the event? How long is the speaker portion of the event? *
Where will the event be located? *
What is your projected audience size and composition? *
Will there be access to media (microphone, podium, laptop for presentation, internet, etc.)? *
Would you like to include products for the event as a part of your package? If so, what products? *
Required
Do you have a budget for this event? If so, what is your speaker budget? *
What date would you like a speaker confirmation? *
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DD
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Please provide any other helpful information about your event.
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