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:?
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
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?
Full Name

First NameLast Name
Address

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