Neshama Alheem Speaking/Training Questionnaire
Please complete this speaker/trainer request form with all relevant details.
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Email *
Please enter your first name. *
Please enter your last name. *
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.) *
What is the date of the event? *
MM
/
DD
/
YYYY
Where will the event take place (city, state, and venue)? *
What is the name of your company or organization? *
Is there an event website? If so, please enter it below. (If not, please type "N/A".) *
What type of engagement would you like from  Neshama for this event? *
If you selected "other" above, please specify the type of engagement below.
How long would you like Neshama to speak/train and what is the topic? *
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. *
Will the event be recorded? *
Is selling from the stage allowed? *
Please provide your speaker budget below for Neshama, including any important considerations like travel, lodging, attendee materials provided, etc. *
A copy of your responses will be emailed to the address you provided.
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