Hi there! I'd be happy to speak at your event.
I just have a few questions for you!
What is your name? *

What organization do your represent? *

What is the purpose of your event? *

If possible, please note the audience size, demographic, and age.
What topic would you like me to speak about? *

Where will your event be? *

Please include city, state, and venue.
When is your event? *

At what time would you like me to speak? *

What is your speaker fee budget? *

Please note that travel and lodging expenses are required and are separate from the speaker fee.
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