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Neshama Alheem Speaking/Training Questionnaire
Please complete this speaker/trainer request form with all relevant details.
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Email
*
Your email
Please enter your first name.
*
Your answer
Please enter your last name.
*
Your answer
Please enter your BEST email address to contact you regarding this inquiry. (This will be the email address we use for all communication going forward.)
*
Your answer
What is the date of the event?
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MM
/
DD
/
YYYY
Where will the event take place (city, state, and venue)?
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Your answer
What is the name of your company or organization?
*
Your answer
Is there an event website? If so, please enter it below. (If not, please type "N/A".)
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Your answer
What type of engagement would you like from Neshama for this event?
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Keynote speech
Workshop or Training
Panelist
Podcast Interview
Virtual conference or training session
Other
If you selected "other" above, please specify the type of engagement below.
Your answer
How long would you like Neshama to speak/train and what is the topic?
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Your answer
Please use the space below to outline the demographics of the event attendees, the number of attendees expected, and the needs of the audience that will be addressed at the event.
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Your answer
Will the event be recorded?
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Yes
No
Is selling from the stage allowed?
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Yes
No
Please provide your speaker budget below for Neshama, including any important considerations like travel, lodging, attendee materials provided, etc.
*
Your answer
A copy of your responses will be emailed to the address you provided.
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