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19
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1
Name
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First Name
Last Name
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2
Email
*
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example@example.com
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3
Phone Number
*
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Area Code
Phone Number
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4
Organization/School/Company Name:
*
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5
Role/Title
*
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e.g., event coordinator, teacher, HR rep, etc.
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6
Event Name:
*
This field is required.
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7
Date & Time:
*
This field is required.
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8
Event Location
*
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Physical address or virtual platform
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9
Estimated Audience Size
*
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10
What topics are you interested in?
*
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The Inside Scoop: Navigating the Modeling Industry
Model Ready: Mastering Modeling Techniques
Confidence is Key: Empowering creatives for Success
Body Positivity and Diversity in Fashion
Fashion Forward: Trends and Careers in the Industry
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11
Speaking Format:
*
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Keynote Speech
Panel Discussion
Workshop/Interactive Session
Q&A Session
Other
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12
Will this be a paid opportunity?
*
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Yes
This is a give-back opportunity
Type option 3
Type option 4
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13
Will travel/accommodation be provided if necessary?
*
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Yes
No
Not applicable
Type option 4
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14
Do you need any special accommodations or materials from me?
*
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15
What tech/setup will be available?
*
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Microphone, projector, etc.
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16
Anything else I should know about the event or audience?
*
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Huge
Large
Normal
Small
Ok
quote
Created with Sketch.
Ok
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17
How did you hear about me?
*
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Social media
Referral
Website
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18
Would you like to be added to my email list for future updates?
*
This field is required.
YES
NO
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19
Thank you for your interest!
I appreciate you considering me for your event. I review all requests as soon as possible and will respond within 3 days to discuss details. Looking forward to the possibility of working together!
I understand that I will receive a response via email within 3 days!
Perfect, talk soon!
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