Empowered 2 Thrive Cruise Speaker Request

Empowered 2 Thrive Cruise Speaker Request
Full Name*

First NameLast Name
E-mail*
Website address*
Phone Number*

Area CodePhone Number
What topic(s )do you cover:?*

Branding & VisibilityHealth & WellnessSelf Love or PurposeMarketing & Social MediaRelationships: Personal &/or ProfessionalMindset, Clarity or ConfidenceLeadershipPhilanthropy: Making a differenceSpiritualityWomen's EmpowermentMale EmpowermentYouth EmpowermentBusiness StrategiesCorporate: Ethics, Team Building, SalesCommunity & Awareness
Brief Program(s) Descriptions outline(s)*
Briefly tell us about your typical audience. Share your approx following for all Social Media outlets combined*
What contact information would you like us to share with attendees. Please list all avenues.*
Date of Cruise that you wish to speak at*
Do you have valid Credentials for traveling. Must have (#1 or 2) or (3&4) to attend cruise. We recommend passport or enhanced ID

1-Passport2-Enhanced Drivers License3-Valid ID - required4-Birth Certificate -
Once submitted, your information will be reviewed. If all speaking slots have been filled, we will add you to our database for future events.
Upload your Biography

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Send copies, clippings, book you authored or co-authored, live interviews or other relevant media that can be used to help promote you

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Upload photo: Black and white or color headshot (5x7 or 8x10) and/or action photo.

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What peaked your interest the most or made you decide to partner with Empower Cruises? *

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How did you hear about us?*
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Address

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