Wambui Bahati Booking Form

Mark Steiner
417.889.9909 | office

This Form cannot be submitted until the missing fields (labelled below in red) have been filled in
Wambui Bahati Booking Information Form
Please note that all fields followed by an asterisk must be filled in.
First Name*
Last Name*
E-Mail Address*
City*
State/Prov*
Business Phone*
Where did you hear about Wambui?
Which presentation are most interested in?*
If you answered "other" in the field above, please explain.
What is the date of your event?
In what city will the event be held?
Who will attend your event? i.e., students, mainly women, business people, doctors, general public, etc.
How many people will attend?
What is the goal of this event?
What is main 'message', 'feeling' or 'tool' that you would like your audience members to leave with?
Would you like to tell us anything else?
Please enter the word that you see below.