SPEAKING REQUEST QUESTIONNAIRE
Thank you for considering Dr. Inga to speak at your event! Let's start the conversation.
First Name
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Last Name
*
Cell Number
*
Email
*
Name of Your Organization
*
How did you hear about Dr. Inga?
*
Name of your event.
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Time of event
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Virtual or Live Event
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Virtual
Live
Venue Location, If Live:
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Event Website
*
Describe the event you wish Dr. Inga to participate in
*
How many attendees do you expect for your event?
How many times do you wish Dr. Inga to speak at your event?
Event Type
Broadcast Interview (TV or Radio)
Corporate/Business Speaker/Empowerment Speaker
Ministerial/Inspiration Speaker
Set Duration (In Minutes)
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Closest Airport/Station*
Additional Speakers, if applicable
Speaking Date(s)*
Speaking Time(s)*
Please share honorarium allocation
*
Feel free to share any additional relevant information.
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