Interview | Booking Request Form
Thank you for your interest in having Roxana on your platform! We look forward to connecting and learning more about your opportunity.
Name *
Your answer
Email address *
Your answer
Website *
Your answer
Tell us about your interview or appearance request. *
Your answer
Proposed Date(s) and Time(s) *
Your answer
Location *
Details of the proposed location *
Your answer
Social media handles being used for this event. *
Your answer
Do you have a budget for speaker fees? *
Any additional information you think we should know? *
Your answer
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