Speaking Request | Ownership Coach

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DANIELLE GERTNER

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Speaking Request

First Name

Last Name

Email

Phone

Name of Organization

Are you a speakers bureau or agency inquiring on behalf of a client?

Yes

No

Name of bureau or agency

Date of your Event

Are your dates flexible?

Yes

No

Location of your Event:

Street Address

Street Address Line 2

City

Region/State/Province

Postal / Zip code

Country

Approx. number of attendees

What are your biggest pain points? What do you hope to accomplish with this event?

Budget range

Where did you hear about me?

Anything else you'd like to share?

Thank you for your request! Danielle will be in contact soon!

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