Speaker Booking Request Form | C.R.I.P.S.

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C.R.I.P.S.

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🟣 Speaker Booking Request Form

First name

Last name

Company name

Position

Phone

Email

Multi-line address

Country/Region

Address

City

Zip / Postal code

Event Date & Time (or Preferred Timeframe)

Event Location

Type of Event / Audience (Youth, Adults, Professionals etc.?)

Which topics are you interested in? (Check all that apply)

Youth Empowerment

Gang Prevention / Anti-Violence

Reentry / Redemption Stories

Street Survival to Street Leadership

Women's Empowerment

Mental Health & Trauma

Other

Budget / Speaker Fee Range (Optional)

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