Capitol City Speakers Bureau Healthcare Speaker Information Request Form

CAPITOL CITY SPEAKERS BUREAU
Your source for Inspirational Speakers,
Healthcare Speakers, Motivational Speakers,
Healthcare Trainers & Consultants

Inspirational Trainers & Healthcare Speakers
from Capitol City Speakers Bureau

Capitol City Speakers Bureau
Healthcare Clients

Request more information about healthcare
trainers and inspirational speakers for nurses
from Capitol City Speakers Bureau

Contact Capitol City Speakers Bureau
about hiring inspirational healthcare speakers
and motivational trainers for your next event!

CAPITOL CITY SPEAKERS BUREAU
Click here if you are interested in
Business Speakers, Corporate Entertainers
Sports Personalities, Humorists & Illusionists

Request more information
from Capitol City Speakers Bureau

For more information about speakers for your event, please complete the information below and press the Submit Request button, or e-mail us at info@capcityspeakers.com.

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A member of our meeting planning team will contact you shortly!

I am interested in:
Nurses Day/Nurses Week Celebration
Conference Keynote Speaker
Training Sessions
Medical Humorist
Cancer Survivor Event
Community Event
Consulting (Customer Service, Teamwork, etc.)
Other (Describe)

Budget per speaker, excluding expenses:

$2,500 - $5,000
$5,001 - $7,500
$7,501 - $10,000
$10,001 - $15,000
$15,001 - $20,000
$20,001 - $40,000
More Than $40,000

Please send me information on the following speakers:

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Please provide me with:
Biographical Information
Speaking Fees
DVD / Online Video (if available)

Please check the availability of for a meeting on

      Date: * Required Field

      Time:

      Location:

Comments:

Your Name and Information:

Name: * Required Field

Title:

Organization:

Address:

City:

State:

Zip:

Phone: * Required Field

Fax:

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