Empowered 2 Thrive Cruise Speaker Request

Empowered 2 Thrive Cruise Speaker Request
Full Name *

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

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

Branding & Visibility Health & Wellness Self Love or Purpose Marketing & Social Media Relationships: Personal &/or Professional Mindset, Clarity or Confidence Leadership Philanthropy: Making a difference Spirituality Women's Empowerment Male Empowerment Youth Empowerment Business Strategies Corporate: Ethics, Team Building, Sales Community & 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-Passport 2-Enhanced Drivers License 3-Valid ID - required 4-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
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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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 Name Last Name
Address

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