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Want your event to transform the lives of those in attendance?

Name

Phone Number

Name of upcoming event

Date of Event

Website

Type of event

Virtual

In Person (Live)

Estimated number of attendees?

What are the demographics of your attendees?

Provide a brief description of the event and it's mission

What is your budget for hiring a keynote or headline speaker for your event?

Will Travel and hotel accommodations be covered? please share the dollar amount (just type 0 if virtual)

Will Dr. Angela have the opportunity to sell her products or services?

Why do you think Dr. Angela will be a great fit for your event?

Please provide the names of other people of influence speaking at this event

Anything else you want us to know?

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