Please fill out this form if you are interested in inviting Dr. Margaret to speak for your organization or event.

Organization Name

Website

http://

Event Title, Dates, Times, & Location

Expected Number of Attendees

Presentation Topic & Duration

Is there a specific topic you would like Dr. Margaret to speak on? What is the number and length of sessions you would like Dr.Margaret to speak? What types of sessions are these: keynote speaker, breakout session, etc?

Organizer Name

First Name

Last Name

Organizer Email

Budget for Honorarium, Travel, Accommodations

Please include amount for honorarium, as well as travel and hotel accommodations.

Anything else that would be helpful for us to know about your speaking request:

Event Website

http://