Speaker Interest
Thank you for your interest in speaking at War On Divorce Marital Wellness Conference. Please provide us with the following information so we may keep in contact with you. We don't want you to miss all the great opportunities ahead! Please note, not all speaking opportunities are paid.
Full Name
*
First Name
Last Name
Spouse Name
First Name
Last Name
How long have you been married?
Please Select
0 to 5 years
5 to 15 years
15 year or more
What is your anniversary date?
Do you have any relevant credentials related to couseling, coaching, marriage, etc.? (LPCT, Coaching Certifications, Degrees)
Yes
No
Do you have any experience public speaking and/or conference speaking?
Yes
No
Please list subject matter expertise and/or speaker topics you are versed in.
Which opportunities are you interested in?
War On Divorce Conferences
Co Author Opportunities with Drs. Noble & Kim Evans
Marriage Bootcamps
Other Marriage Training and/or Marriage Coaching Opportunities
Paid Opportunities Only
Non-Paid Brand Elevation Opportunities
Vendor Opportunities
If you are seeking vendor opportunities, please share information about your product or services here. (Include any social media handles)
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Format: (000) 000-0000.
E-mail
example@example.com
How did you hear about us?
*
Please Select
Social Media
Internet
Magazine
Other (Please specify...)
Other
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Professional Headshot or Images of You and Your Spouse
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