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PILLAR Retreat Sponsor Speaker Details
YOUR DETAILS
Name
*
Preferred Title/ Identifier
(ex: Founder/CEO/Owner)
Phone
*
Preferred Email Address
*
Bio (2-3 Sentences)
*
Upload your headshot
*
Accepted file types: jpg, gif, png, Max. file size: 128 MB.
Upload a family photo (optional)
Max. file size: 128 MB.
You may choose to include a family photo with your service member in uniform.
Please share your #1 tip for a successful deployment countdown
What's your favorite song to play during deployment?
T-SHIRT TIME!
What is your preferred t-shirt size?
XS
S
M
L
XL
XXL
Your Home/Shipping Address
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
GIVEAWAYS & DISCOUNTS
Would you like to include a discount code for attendees to include in the Digital Guide?
Yes
No
Please describe your discount code
ex. (20% off your full order from *shop name*, expires 12/1/20) OR ex. (10% off your purchase of *product* from *shop name* never expires)
Discount Code
Share the code that can be used by all attendees This code should be available for use beginning Nov 12 2020
Are you interested in highlighting your product/service by hosting a giveaway during the retreat?
Yes
No
Name of giveaway item:
Description of giveaway item:
Image of giveaway item
Accepted file types: jpg, png, Max. file size: 128 MB.
This is the image we will use to promote your product and your company. Please use a high-resolution, quality product or lifestyle photo.
How many of this item would you like to give away?
1
2
3
Agreement
*
I agree to the PILLAR Speaker Terms
By submitting this Speaker Detail form, I agree to participate in the PILLAR Digital Retreat for Deployment Countdowns as a featured speaker. I agree to treat all retreat logistics, technology and other proprietary information as confidential. I understand that I am volunteering my time in support of this free virtual retreat for military spouses and have not been guaranteed nor will I seek out monetary or other compensation for my participation.
In alignment with the PILLAR Deployment Retreat mission and vision, I affirm my commitment to supporting military spouses and significant others across all branches without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status. When we say all military spouses we mean ALL!