Speaker Request

First Name*

Last Name*

Email*

Phone Number*

Organization Name

Event/Podcast/Website

EVENT INFORMATION:

Please include details about your upcoming event or proposed event below.

What's the event/program name?*

What type of appearance are you interested in booking Stephanie for?*

When is your event date?*

Month/Day/Year

Where will the event be hosted?*

In-person

Online

How many days will you need Stephanie at the event? Put 1 if not an event*

How many attendees are expected?*

How did you hear about Stephanie? *

If you were referred or heard/saw Stephanie speak, please tell us who we should thank

Give full details about the event including details about the attendees/listeners/readers (target audience), their spiritual challenges, and the purpose of your organization/program/event.*

Please suggest or describe a topic you had in mind or a focus you would like Stephanie to cover during her appearance.*

If travel is required, you understand Stephanie's travel costs are covered by your company or event host (including airfare, transportation, and lodging). Reasonable and safe accommodations are required, and will be included in the proposal.*

No travel is required

Yes, I understand

What is your estimated speaker budget (including travel)? Write N/A if travel isn't required *

Does this require a call to discuss further?*

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