Booking Request
Request our Host Speaker(s).
*Please Note
We do not participate in debates of any kind, or liberal / RINO events.
Your Organization
*
Authorized Representative
*
First Name
Last Name
Email
*
example@example.com
Phone
*
Please enter a valid phone number.
Speaking Engagement Type
*
Please Select
In-Person
Virtual Only
Virtual Only Date & Time
In-Person Date & Time
Event Venue Address
Street Address
Street Address Line 2
City
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Washington
West Virginia
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State
Zip Code
Website
*
Is this a Conservative / Republican Event?
*
Please Select
Yes
No
Event Topic & Description
*
Event Flyer / Media
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Expected Audience Size
*
Will Event be Recorded / Streamed?
*
Please Select
Yes
No
In addition to applicable expenses, please select your Honorarium offering
*
Please Select
$250 or More
Honorarium Payment
*
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USD
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Credit Card Details
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Last Name
Credit Card Number
Security Code
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Authorized Representative Signature
*
Digital Signature
*
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Date
*
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Day
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