Speaker Application
Thank you for your interest in speaking at 2021 Angel Moms Brunch. Please find our speaker application below. For more information or if you have any questions please email us at info@quilasangels.org.
Name
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First Name
Last Name
E-mail
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Confirmation Email
Are you applying for yourself or someone else?
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Myself
Someone else
If someone else, please provide your name
Headshot
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Browse Files
This photo will be used on our website and social media outlets
Cancel
of
Biography
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Company / Organization Name
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Title
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Company / Organization Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
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-
Area Code
Phone Number
Social Media Handle(s)
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Why do you want to speak at the Angel Moms Brunch?
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Title of speech
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Topic(s) that you will be discussing:
Pregnancy Loss
Infant Loss
Infertility
Abstract: Your session abstract will tell Brunch Attendees why they should attend your 30 minute session. To be effective and create interest, it should provide a brief, clear, and concise reflection of your presentation content. The abstract should only be one paragraph of between 150 to 250 words in length.
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Have you given this presentation before and/or you do you intend to present it elsewhere in the near future?
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Yes
No
If YES, please provide the URL below - If NO place N/A in the box.
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Are there any questions you want our host to ask you?
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If yes, please provide your questions above.
Do you have any questions to ask our host?
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If yes, please provide your questions above.
I consent to Angel Moms Brunch posting my speech on their website, future communication/newsletters produced by Angel Moms Brunch and Quila’s Angels Inc. I consent to Angel Moms Brunch / Quila’s Angels Inc to capture a video/audio recording and pictures of my speech and making it available to brunch attendees on their website and social media outlets. I understand that I will not receive any compensation for speaking at any Quila’s Angels Inc / Angel Moms Brunch Event/Summit.
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Yes
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Submit You Speaker Application
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