Speaker Request Form
Thank you for your interest in booking Tiffynee, also known as Sexologist Tiffynee. Please complete this form in its entirety. Tiffynee will contact you within 48 hours to discuss your booking request
Name
*
First Name
Last Name
Email
*
example@example.com
Company / Organization
*
Contact Number
*
Please enter a valid phone number.
Name of Event
*
Date of Event
*
-
Month
-
Day
Year
Date
Address of Location
*
Virtual or In Person
Time of Event
*
Ex: (2pm or 10am)
Type of Event
Expected # of Attendees
*
What is your Speaker Budget?
*
How would you like Tiffynee to Contribute to your Event?
*
Keynote Speaker
Workshop Facilitator
Trainer
Panelist
Podcast Guest
Social Media Post
TV Show Guest
Other
How long will you need Tiffynee to speak?
*
What topic would you like Tiffynee to speak on?
*
Will Tiffynee be able to Promote any of Her products/Services?
*
Yes
No
Let's Talk About It!
Will Travel accommodations be needed? Pease keep in mind Tiffynee is located in Houston, Texas?
*
Yes
No
N/A
Is there any additional information you would like Tiffynee to know or consider?
Submit
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