Name
*
First Name
Last Name
E-mail
*
Organization
Reason for event/context
*
Online/live
*
Live online
Live in person
Online recorded
Podcast
Other
If in person, where?
Suggested presentation length
*
Suggested dates & times for your event
*
Are these dates flexible?
*
Audience demographic
*
How many are expected to attend your event?
*
Proposed topic
*
Budget
*
Any other details?
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