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)

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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 *

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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 Shari Cuesta at: PowermovesImpact@gmail.com
Phone: (612) 804-0799 Fax: (651) 344-0671

www.PowerMoves.org

PowermovesP.O. Box 22567Robbinsdale, Minnesota 55422email Shari Cuesta at: PowermovesImpact@gmail.comPhone: (612) 804-0799 Fax: (651) 344-0671

www.PowerMoves.org

Powermoves
P.O. Box 22567
Robbinsdale, Minnesota 55422
email Shari Cuesta at: PowermovesImpact@gmail.com
Phone: (612) 804-0799 Fax: (651) 344-0671