Booking

Would You Like to Have Steve Speak At Your conference, Office Event, School, University Or For Your Employees? Take The First Step, Complete This Form!

PowerMoves Event Request Form (ERF)

The information you provide here will help us serve you better. Please complete this form and click the submit button at the end.

Engagement Information

Date Form Completed *

Date of Event(s) *

Type of Event(s) *

Location of Event(s) *

Address *

City/state/zip *

Start Times of Event(s) *

End Time of Event(s) *

No. of Sessions *

No. of Attendees *

Duration of Talk *

Approximate ages of Attendees *

Theme/Title of Event *

Contact Person's Name and Title *

First

Last

Work and Cell Numbers *

Fax Number *

Email *

Group Sponsoring Event *

Sponsoring Group's Full Business Address *

Comment *

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PowerMoves
P.O. Box 22567
Robbinsdale, Minnesota 55422
email Siona Fitzhugh at: [email protected]
Phone: (240) 746-2220 Fax: (651) 344-0671

www.PowerMoves.org

PowerMovesP.O. Box 22567Robbinsdale, Minnesota 55422email Siona Fitzhugh at: [email protected]Phone: (240) 746-2220 Fax: (651) 344-0671

www.PowerMoves.org

PowerMoves
P.O. Box 22567
Robbinsdale, Minnesota 55422
email Siona Fitzhugh at: [email protected]
Phone: (240) 746-2220 Fax: (651) 344-0671