Speaker Request Form

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Budget (range) Budget (range)$0$100-1000$1000-2000$2000-3000$3000-4000$4000-5000Other (please specify in other comments)

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Event format (e.g. conference keynote, workshop etc.) Event format (e.g. conference keynote, workshop etc.)ConferenceFilmKeynote SpeechPodcastWorkshopOther (please specify in other comments)

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