Speaker Request Form
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Date of Event:
Presentation Start Time:
How did you hear about
Overview of Audience (career professionals, entrepreneurs, moms, etc.)
Audience Age Range:
What goals or objectives do you want the presentation to address?
How do you want the audience to feel after the presentation? (ex. inspired, informed, educated , etc.):
be allowed to promote any products/services?
Let's Discuss it!
Will travel accommodations be needed? Please keep in mind we are in the Atlanta area.
Any Additional Comments: