Copyright 2013 Janet Zadina, Ph.D. All rights reserved.
Invite Dr. Janet Zadina
to speak to your group
As you are probably aware, there are many details that go into bringing a speaker for your group. Please complete this form and provide as much information as possible. This will assist us in determining whether Dr Zadina is available. Please be aware that this serves as an inquiry only and NOT a confirmation of appearance. This will merely assist us in doing all we can to meet your requested dates. Please answer the following questions and submit this form. Ones marked * are required and others are helpful, but optional. Upon receiving this completed form, we will contact you as soon as possible and answer any questions you may have. If you have any problems with this contact sheet, please email email@example.com.
Please fill out the details below.
Date(s) of Event
I am interested in the following areas (this is important).
In order to better serve you, would you kindly tell us the purpose of your event and what you would like the speaker to achieve? You may describe this in any length.
Length of Presentation:
Keynote: 45-90 minutes Half Day: 2-3 hours Full Day: 4-6 hours