Speaker Intake Form Debra AtkinsonSpeaker Interview 2.0: How, When, and Why Exercise Women 40+ May 6-12, 2024 The recording time is 30 minutes. The booking allows 50 minutes padded time. Web conferencing details provided upon confirmation. Please complete this form before your interview so we'll be ready at your interview time. Name Email Your website: Who is your marketing contact? Email address of your EA/marketing contact Your speaker bio Your Speaker Image Topic (or suggested title) for your talk 3-5 questions or bullet points for your talk What is your Professional Title? What's the size of your email list you plan to promote to? When do you plan to promote/share the summit? (Promotion dates: April 8 - May 5)? Your Social Media Handles: Would you like us to reach out about a live on social with Debra to promote? Yes No Send text messages to Please leave just your phone number without spaces 000-000-1234 Submit Answers