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* 1. First and Last Name

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* 2. Phone Number

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* 3. Email address

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* 4. Bio (in 3rd person)

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* 5. LinkiedIn profile link

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* 6. Other links where we can learn more about you (i.e. Website, news article, social media links, github)

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* 7. What topic (or topics we can choose from) are you interested in speaking on?

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* 8. Please provide further detail on each of these topics

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* 9. Please list previous speaking history including topics, events, locations, size of audience, format, or any other relevant information.

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* 10. When are you available to speak? We typically meet the 3rd Tuesday of each month.

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