Request Tamara Ellison
Event:
*
Location:
*
Address
Requested Speaking date(s):
*
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Month
-
Day
Year
Date
Date Picker Icon
Time of event
*
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
Until
until
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
Target audience:
*
Expected attendance:
Purpose of event:
Event budget for speaker:
*
Describe exactly what you are requesting of Tamara
i.e., keynote speaker, special seminar, workshop leader, event moderator
During event what time will Tamara be speaking?
*
Please give us a brief history of this event:
i.e., previous speakers, past attendance, annual (if so, how many years)
Organization phone number:
*
-
Area Code
Phone Number
Organization website:
Your Name:
*
First Name
Last Name
What is your role with planning the event?
*
Decision Maker
Event Planner
Committee Member
Interested Party
Your Email Address:
*
example@example.com
Your phone number:
*
-
Area Code
Phone Number
Will Tamara be able to sell her books and other products at your event?
*
Yes
No
Please upload a copy of the program outline.
*
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