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Speaker Request Form
I look forward to speaking to your group. Please fill out the form below so I can have the basic information about your inquiry and/or event prior to our speaking. You may then feel free to contact me directly at 801.787.8014 or Jonathan@RelateGREAT.net
. Thank you.
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Tell me about you
First Name
*
Your answer
Last Name
*
Your answer
Title
Your answer
Organization
*
Your answer
Phone
*
Your answer
Email
*
Your answer
Website
Your answer
Tell me about your event
If you don't know all the following information yet, as you may still be in the planning stages, just answer as much as you know for now.
Your Event
Tell me a little about the event you'll be holding, what it's for and what you are hoping to get out of it.
Your answer
Speaking Topic
Is there a seminar topic I have that you are interested in and/or are you interested in a custom seminar?
Your answer
Event: Date
Your answer
Event: Time
Your answer
Event: Speaking Length?
How much time are you allocating for the speaker/presentation itself?
Your answer
Event: Format
What is planned for the event in addition to me speaking? For example, is there a dinner before/during, will other business/announcements be made prior, etc?
Your answer
Event: Location, Address, Parking Instructions, Room meeting will be held in, etc.
Please give me as detailed instructions for any of the above.
Your answer
Your People
Tell me a little about the people I'll be speaking to such as age-ranges, gender mix, affiliations, professions, etc. Just anything you would like me to know about the group.
Your answer
Your People: How many do you anticipate attending?
Your answer
What concerns, topics, questions and/or solutions would you most like answered/addressed/covered in Jonathan's presentation on this topic?
Your answer
Any other feedback, comments or ideas?
Your answer
Would you like to receive the "GREAT Relationships eZine" for additional tips, resources and events for how to develop true greatness in your relationships?
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Yes, please.
No, thank you.
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