BOOKING FORM - Natalia Powers

PRE- EVENT QUESTIONNAIRE

Complete for the Form Below

Your First Name

Your Last Name *

Contact's Email

Cell phone

What is your role with planning the event:

Who in your organization is responsible for signing contracts?

Street Address

City

State

Billing Postal Code

Event location: (City | State | Venue)

What is the Date of the Event?

How many people will be attending?

What Date and Time Would Natalia Speak?

What exactly would you like Natalia to do?

What topic would you like her to address?

How long would the presentation last?

Is there more than one appearance requested?

Tell us briefly about the event, it's purpose and demographic of the attendees: