DR. WASHINGTON SPEAKS, LLC
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Speaker Request Form
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Indicates required field
Name
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First
Last
Email
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Area Code + Phone Number
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Name of Organization(s) or Group(s)
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Date(s)
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Time(s)
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Audience Admission Fee(s)
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Budget for Speaker
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Is your organization able to provide a table for attendees to purchase materials from Dr. Washington Speaks, LLC?
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Workshop Topic Request(s)
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Location(s)
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Approximate Number of Attendees & Age Range
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Technology Available for Speaker's Use
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Other Key Details/Comments/Questions
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For speaker requests, include details about your event's date, time, location, format, and number of participants.
Submit
Home
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Speaker Request
Events
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