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Dr. Carmen Cochran

Consultant | Trainer | Speaker

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SISTERHOOD OF SUCCESS

Dr. Carmen is available to speak at your Conferences, Workshops, Trainings, Wellness Retreats, or she can create a tailored program or self-care intensive for your group or organization today!

DR. CARMEN SPEAKER REQUEST

Fields marked with an * are required. If you would like Dr. Carmen to take part in your event, please fill in your details in this Speakers Request Form below and you will be contacted by a member of our team. Please allow 2-3 business days for us to review your request. If you have an event that is less than 3 weeks away, please give us a call to see if we can accommodate your request.

PART 1: EVENT ORGANIZER

NAME OF ORGANIZATION SUBMITTING PROPOSAL

EVENT SPONOR(S)

FOR PROFIT/NONPROFIT STATUS*

For Profit

Nonprofit

EVENT COORDINATOR INFORMATION

FIRST NAME*

LAST NAME*

EMAIL*

TITLE*

PHONE*

MESSAGE

EVENT DATE

START TIME

EVENT TYPE*

BUDGET FOR THE EVENT*

PRESENTATION/SPEECH DETAILS*

PRESENTATION FORMAT

Roundtable

Panel

Training

Other

EXPECTED DURATION (HOURS, DAYS)

QUESTION & ANSWER (WILL THE SPEECH BE FOLLOWED BY A Q & A SESSION?)

Yes

ARE CEU'S NEEDED?

Yes

AUDIENCE DETAILS

AUDIENCE (APPROXIMATE SIZE OF AUDIENCE. BRIEFLY DESCRIBE ITS MAKEUP AND IF MEMBERSHIP IS REQUIRED TO ATTEND.

HONORABLE QUEST(S): (LIST NAMES + TITLES OF MEMBERS OF PROMINENCE, VIPS, PARTICIPATING IN OR ATTENDING THE EVENT).

MEDIA: WILL MEDIA BE INVITED? IF SO, WILL THE EVENT BE OPEN OR CLOSED PRESS? ALSO, DESCRIBE AND SUBMIT THE MEDIA LIST).

ADDITIONAL INFORMATION

DEADLINE FOR ACCEPTANCE

COST OF ATTENDANCE (PLEASE INCLUDE MEMBER AND NON-MEMBER PRICE, IF APPLICABLE).

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Dr. Carmen Cochran

Consultant | Trainer | Speaker

HOME
ABOUT
LET'S WORK TOGETHER
MEDIA
SISTERHOOD OF SUCCESS

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