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Welcome
Thanks for your interest in having Steve partner with your organization. To best assess fit and so we can follow-up appropriately please fill out this short survey.
11
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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
Date of Event
*
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(If the date is not finalized, please put a tentative date)
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Date
Year
Month
Day
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5
Name of Conference or Event
*
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6
Event Location
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7
Expected Number of Attendees
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8
Event Type
*
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Public Industry Conference
Private Conference
Private Event
Workshop
Other
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9
Speaker Budget?
*
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Exclusive of customary expenses
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10
What type of talk would you like Steve to do?
*
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Keynote
Panelist
Workshop
Strategy Session
Other
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11
Thank you for submission. A member of our management team will be in touch with you shortly.
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