Speaking Engagement Request
Please fill out the form below to request a member of the Permian Strategic Partnership leadership team to attend a conference, panel or other speaking engagement. You will hear from a member of our team shortly after submission.
* Required
Email address
*
Your email
Name of Organization
*
Your answer
Name of Event
*
Your answer
Event Date
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MM
/
DD
/
YYYY
Event Time
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Time
:
AM
PM
Event Location
*
Your answer
Summary of Event
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Your answer
Topic(s) Speaker Can Expect to Address
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Your answer
Will there be other speakers? Please provide additional names if applicable.
*
Your answer
Expected Audience Size and Makeup
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Your answer
Will questions be taken from the audience?
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Yes
No
Will elected officials be in attendance? If so, please provide names and titles.
*
Your answer
Will the event be recorded?
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Yes
No
Sample Question(s) for Speaker
Your answer
Contact Information
*
Your answer
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