Speakers Request
Please take a moment to fill out the form.
Name
*
First Name
Last Name
Phone Number
*
E-mail
*
example@example.com
Date of the event
Preferred Type of Speaking
*
Keynote
Half day training
One day training
Two days Training
Other
Your Speaker's fee Budget (Mandatory) If there this field left empty we can't process your request
*
Will you pay for travel?
Is this a grant?
Yes
No
Your Billing Address:
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Time of Timea Nagy's Presentation
Hour Minutes
AM
PM
AM/PM Option
Number of Audience
*Up to 100 attendees Timea's Cause will provide the platform, over 100 attendees please inquire
Ticket Price
Website link for your organization/previous events
Are there Sponsors or Grantors funding this event?
How did you hear about Timea Nagy?
Your goal with this presentation
Inspirational
Raising awareness
Training
Community Building
Facilitating
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