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Thanks for your interest!

What's your first and last name? *

What is your email address? *

What is your website? *

What is your city and state of residence? *

What is your title and company? *

Proposed speaking title and description *

(Please include your unique perspective on health/wellness and what you would like the attendees to walk away with)
Please share your speaking experience, published articles, and/or books. *

List each experience and include links, if any
What qualifies you to lead a workshop? *

Please include why you are the best person to lead this workshop?
Have you attended a TPC Retreat? If so, which one? *

Do you have anything else you would like to share with us?

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