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Speaking Form
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* Indicates required question
Email
*
Your email
First Name
*
Your answer
Last Name
*
Your answer
Telephone #
*
Your answer
What topic would you like covered?
*
Fitness (444to200)
Business (Hungry2Huynh)
Globesity (JustHuynh)
Other:
Required
What is your audience size? (min 150 for maximal impact)
*
< 150
150 - 499
500 - 999
1,000 - 4,999
5,000 - 9,999
>10,000
Other:
What are your intended event dates?
*
Your answer
Where will speaking event be held? (i.e. location address)
*
Your answer
How long would you like me to speak for? (presentation + Q&A)
*
30 minutes
60 minutes
Other:
What is ticket price for event attendees? (USD)
*
Your answer
What is your speaker fee to bring me in? (USD)
*
<$5,000
$5,000 - $9,999
$10,000 - $24,999
$25,000 - $49,999
$50,000 - $99,999
$100,000 - $249,999
$250,000 - $499,999
>$500,000
Other:
Are there pre or post conference events to consider for travel planning?
*
Your answer
What's the call-to-action that you'd like your audience to have from my talk?
*
Your answer
A copy of your responses will be emailed to the address you provided.
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