Please complete the form below to request for Phillip Roundtree to be a part of your event.

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First NameFirst name
Last Namelast name
Phonephone number
Companycompany
Company Addresscompany address
Company Citycompany city
Company Statecompany state
Company Zipcompany zip
Event Date(s) of Interestmore details
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Organization Type
Projected Budget for Securing Services
Event Name
Event Time
Purpose of Event
0 /
Planned Number of People Attendingpick one!
Event Attendee Demographics
0 /
Will This Event Be Open To The Public?pick one!
Will Tickets Be Sold For This Event?pick one!
Do You Intend To Record Or Live Stream This Event?pick one!
Can Products Be Sold At This Event?pick one!
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