JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Zaretta Hammond -- Speaker Request
Hello Friend,
I am excited about the possibility of partnering with you on your upcoming event.
To help me better serve you, please answer the following questions in preparation for our scheduled call.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Your Full Name
*
Your answer
Your position / title
*
Your answer
Your school or organization name
*
Your answer
Your school/organization's city and state
*
Your answer
Speaking date (include options if available)
*
Your answer
Will the engagement be virtual or in-person?
In-person
Virtual
Clear selection
Closest major airport?
*
Your answer
Please share information about your event: Who is the audience? How many attendees are you expecting?
*
Your answer
What is the theme?
*
Your answer
What topics would you like covered during the engagement?
Your answer
How can I best serve your audience during this event?
*
Your answer
Can you share some information about past events: Who have been past speakers? Previous themes?
*
Your answer
What has been your experience with my book, Culturally Responsive Teaching and the Brain? Have you or your staff attended past events (i.e., workshops, webinars, keynotes at other events) I have hosted?
*
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
