Theodore Teddy Bear Schiele
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Motivational Speaking Form
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Name
*
First
Last
Phone
Work Email
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Business Type
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Please Select
Nonprofit
For Profit
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Company Name
*
Your Position/Title:
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Event Details
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Event Name:
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Event Date and Time
Date
Time
Event Location (City, State)
Virtual or In-Person:
Virtual
In-Person
Estimated Number of Attendees:
Selected Value:
1
Audience Demographics (e.g., age range, profession)
What is the main goal of the event?
What topics or themes would you like me to address?
Are there any specific messages or outcomes you want the audience to take away?
Duration of Speech: (Minutes)
Selected Value:
1
Audio/Visual Equipment Available
Microphone
Projector
Screen
Laptop or Computer
Other (please specify)
Will there be a Q&A session?
Yes
No
I acknowledge that this is a booking inquiry and that final details will be confirmed separately.
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