TO INVITE DR. JANELLE LOUIS TO SPEAK, PLEASE COMPLETE THIS FORM
SERIOUS INQUIRIES ONLY
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Type of Event
*
Select one
School/Student Event
Healthcare Professional/Educational Event
Faith-based Event
Corporate Event
Media
Other
Organization Name
*
Location (City, State/Country)
*
Dr. Louis is available to speak worldwide.
Description of Event, Conference, or Service
*
Date of Event
*
Please list all possible dates, with year included.
Estimated Attendance
*
Select one
<200
200-400
400-800
800-1200
1200-2000
2000+
Not applicable (e.g. media, etc.)
Can Products/Services Be Sold Afterward?
*
Can Leads Be Collected From Audience?
*
Event Contact Name
*
First
Last
Event Contact Email
*
Event Contact Phone Number
*
Website
Name
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