MAKE A SPEAKING ENQUIRY

If you would like to make an enquiry or book a speech or workshop with Dr Frances Pitsilis, please complete the form below. If you prefer you can download a printed version (to the right) and fax it to us.

NB: Fields marked with an asterix (*) must be completed.

Your Name:*
Company Name:
Phone:*
Mobile:
Email:*
Website:
Contact Person:
Event:
Event Date:
Event Location:

Please provide some initial information to enable Dr Frances to quickly assess whether she can help you. Please note: all information supplied will be kept strictly confidential.

How many presentations do you require?

What time(s) will the presentation(s) be?

What will the length of each presentation be?

What type of presentation do you require? (e.g. Key Note Conference, Event Speech, Workshop, Seminar, Master of Ceremonies.)

What is the medium of the presentation? (e.g. Spoken, Written, Television, Radio.)

What business are you in?

Who is the audience?

What is the general message you wish to convey?

What is the outcome you desire as a result of the presentation(s)?

Do you have any special requests?

Do you have any other comments or information?

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