2023 ADL Conference Speaker/Presenter Application

Billing information

First name*

Last name*

Email for order confirmation*

We'll send your receipt and other important info to this email.

Country

Address*

Address line 2 (optional)

Zip code*

City*

State*

This product is for someone else

Participant info

First name*

Last name*

Email*

Chapel #

Mobile Phone

Mobile Phone*

Company/Name for Healer/Vendor

My presentation will be:

20 minutes

40 minutes

Description of presentation:

Do you require AV?

Yes

If yes, what do you require?

Your Website URL

Your Facebook Page URL

Your Instagram URL

Your Twitter Handle

Your YouTube Channel URL

Your payment

Your price

Speaker/Presenter
$0

Have a coupon code?

Coupon code

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