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Cicely Lewis Appearance Request Form
Fill it out the form below to request an appearance for Cicely Lewis. Learn more about Cicely by visiting
www.readwoke.com
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Preferred Date
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Alternative Date
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Available Budget for Honorarium
*
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Available budget for expenses (Please skip if this is a virtual event)
Click here to view Media Kit and Fees
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Name of Institution/Address
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Host/Contact Name
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Host/Contact Phone/Email
*
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Please describe the presentation you'd like Cicely to give, including the format, theme, number of participants, and number of sessions.
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