Other Formats:
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Speaking Request Form
Breast Friends...
"Helping women survive
the trauma of breast cancer...
...one friend at a time"
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| Event Details |
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Company/Organization:
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| Date of Event: |
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| Title/Purpose of Event: |
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| City/State of Event: |
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| Size of Audience: |
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| Length of Presentation: |
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| Who should we contact regarding this event? |
| Name: |
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| Phone Number: |
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| Email: |
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| Mailing Address: |
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| Is there anything else we should know about this event? |
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Please note: Speaking fee and travel expenses will be determined based on purpose, size, and location of event.
1. Print and mail this form to:
Breast Friends
8152 SW Hall Blvd #301
Beaverton, OR 97008
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3. Print and fax this form to:
503.626.8188
(Dial 1 if outside Portland, OR)
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2. Email us:
mail@breastfriends.com
olson.becky@comcast.net
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4. Call us:
503.598.8048 (Portland, OR Metro)
888.386.8048 (Outside Portland, OR - Call Toll Free)
503.309.8188 (Becky's Cell)
503.349.3846 (Sharon's Cell)
(Dial 1 if outside Portland, OR)
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