SPEAKING REQUEST

SPEAKING REQUEST

Thank you for considering CAN BE THE LIGHT to speak at your event! Let's start the conversation.
Contact name*

First NameLast Name
Date*

MonthDayYear
Date
License or Identification Number*
Contact Email*
example@example.com
Contact Phone Number*

Area CodePhone Number
How did you hear about CAN BE THE LIGHT?*
Name of Your Organization*
Name of your event*
How many attendees do you expect for your event?*
In one word, how will your event help your audience?*
Example: Inspire
Describe the nature of your event?*
What would you like for CAN BE THE LIGHT to contribute to your event?*
Will there be additional guest speakers at your event? *
If so, please share the names of your other guest speakers
Where is your event located?*
Example: Podcast or New York City
If your event requires travel, please provide the address below:*
1234 Main Street Los Angeles, CA. 55555
How long is your event?*
Example: 2 Hours
Speaking Date(s)*
Speaking Time(s)*
How many times would you like for CAN BE THE LIGHT to speak at your event?*
What is the Attire for your event?*

ProfessionalComfortable CasualBusiness CasualDo your thing!
What is your budget for CAN BE THE LIGHT to speak at your event?
Please attach questions below if this is an Interview

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Please leave any additional information about your event that you would like to be known ahead of time.
Disclaimer: The information provided is completely private and confidential. This information will not be shared for any reason, and is for internal purposes only. The submission of this form is not an approval for your request. You will receive a direct email with the status of your approval. Thank you for your consideration.
We will review your information and get in contact with you soon!
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