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Charlie R
o
cket
Book Charlie
BOOKING
FORM
Complete the form below if you'd like more information about hosting Charlie at your event.
About You
First Name
Last Name
Position
Email
Company Information
Company Name
Company Phone
Company Website
Organization Type
College or University
Non Profit (Religious)
Non Profit (Non-Religious)
Professional Sports Organizations
Corporate
Other
Company Address
Event Details
Event Name
Event Theme
Event Date(s) of Interest
Event Budget for Speaker MUST input dollar amount
Venue Name and Address
Closest Airport:
Will tickets be sold for this event?
Yes
No
Planned Number of Attendees
Will this event be open to the public?
Yes
No
Do you intended to record or livestream this event?
Yes
No
Presentation/Speech Details
Event Start Time
Speaking Time
Expected Duration
Topic Chosen for Presentation
Dream Crazy
Marketing Innovation
Additional Information
Submit
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