Contact Form
Please complete the following form fully if you’d like to hire me to speak at a conference or work with your school or district. I’ll receive your information via email and will be back in touch promptly. Please do not leave any questions unfinished.
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Email address
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Your email
Name of Organization/Institution
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Your answer
When are you looking for this PD?
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YYYY
What kind of Professional Development?
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Speaking Engagements
In Schools
Workshops
Curriculum Development for Educator's Guides
Equity Reader
Other:
Primary Contact (First and Last Name and Title)
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Your answer
Contact Number
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Your answer
School/Organization Mailing Address (for Contract and Invoice purposes) Street, City, State, Zip Code
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Your answer
School/Organization Physical Address (If different from mailing address)
Your answer
Amount of people for professional development (approximately)?
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Your answer
Are you interested in a one day event or series?
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Your answer
What type of professional development has your school/organization had before this?
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Your answer
Special Circumstances (Are there special requirements for Contracting or Invoicing?) Please specify or state none.
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Your answer
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