Emily W Dean
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Speaking Request Form
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Thank you for your response. ✨
Name/Title Position
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Email
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Phone Number
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Description of Event
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Message
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Date(s) of Event/ Times
(required)
Church/Organization Name
(required)
Church or Organization Website
(required)
Type of Event
(required)
Event Location (address)
(required)
Theme/Topic of Event
(required)
Is there a particular scripture you would like me to speak on?
Speaking Sessions- how many/length
(required)
Attendees
*Describe estimated number and description of their age and lifestyle
(required)
Budget for Speaker’s Honorarium
(required)
Any extra comments
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