Global Women Speakers Intake Form

Sharing your Messages, Products and Services around the Globe while creating Moments, Memories & Once in a Lifetime Experiences!
Your Name*

First NameLast Name
BEST E-mail*
example@example.com
BEST Contact Number*
Social Media Handles/Usernames:*
What's your Social Media Platform of choice MOST Active and Engaged?*

FacebookInstagramYouTubeLinkedInTick Tok
What amazing woman referred you OR how did you hear about Global Women Speakers?*
What's the Name of Your Business *
Type of Business*
Which Irresistible Product or Service you offer?
What's Your Subject or Expertise?*
Who is your "ideal client", "Avatar" or Who do you serve?
What's your current MONTHLY income?*

Under $5,000$5,000- $10,000$10,000 - $20,000$20,000 - $50,00050,000 and ABOVE
Are you interested in a TEDx Talk?

ABSOLUTELY!What is a TEDx Talk?no, not at this time
Where is ONE place you would like to TRAVEL (country, continent, etc)?*
Signature*

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