Speaker Booking Form
Dr. Tinita O. Kearney (aka Dr. T) provides interactive presentations geared towards empowering her audience by creating a highly engaging environment. Once you've completed this request form, you will be contacted to discuss details and to complete the booking process. Feel free to send questions to info@finalpiecetherapy.com or visit www.tinitakearney.com.
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Email *
Name of your organization
Contact name and title *
Phone number
E-mail *
Preferred contact method *
Required
Who will be the audience for this interactive presentation? *
Required
How long would you like the presentation to last?
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Do you have a specific topic that you would like Dr. Kearney to include in her presentation?

Note: General topic options include: 
- Culturally Responsive Practices
- Autism
- Culturally and Linguistically Diverse Populations
- Child Language Disorders
- Special Education
- Literacy
How many participants are expected to be in the audience? *
Required
Would you like for this presentation be delivered in-person or virtually? *
Please list the proposed DATE, TIME (include time zone), and LOCATION (city/state) for your event. A range of date/time options is also acceptable to provide (e.g., Any weekday the week of [date] to [date] between [time] and [time] at [location]) *
Are you interested in pre-ordering books for the event? *
Are there any other important details that you would like to share?
Questions and comments
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