DR. V, SPEAKER REQUEST FORM
Dr. V (Valecia Brooks Dunbar, DM, MPA) is an author, speaker, conversationalist, and leadership confidence coach who is on a mission to develop more confident leaders, empower individuals to act on their dreams, and create life-changing opportunities to help women and all people reach their full potential.
She is often asked to speak on issues of leadership development, entrepreneurship, marketing, professional development, economic empowerment, and global gender equity.
Her signature talks include:
Self-Doubt: How do We Reverse Our Confidence Killers?
Relational Confidence: Why Your Career Relationships May be Blocking Your Success
Discover Your Confidence Zones
Women and Confidence: Take Command of Your Power Center
Lack Confidence? Why Self Esteem Programs Have Missed the Mark
We will meet with any group, panel, or audience that seeks to improve lives, resolve civic or social challenges, or improve the world's social equity by educating and training others to take command of their lives through self belief, personal and professional development, and optimism.
Bio:
https://about.me/drvbrooksdunbar
Media Kit:
https://docs.wixstatic.com/ugd/0d823c_f6372e59afbc4f79a89cd95dc05b0d11.pdf
For best results, please submit your request at least 90 days in advance.
Responses typically occur within seven days. If immediate response is needed please email drdunbar@TheCenterForConfidence.com,
* Required
Email address
*
Your email
Organization Name:
*
Your answer
Point of Contact for Organization (include their email, full name and phone number):
*
Your answer
Organization Alternate Email:
*
Your answer
Event Title (include a brief summation of the event):
*
Your answer
Date of Event
*
MM
/
DD
/
YYYY
Time of the Event:
*
Time
:
AM
PM
Event Location (please be specific)
*
Your answer
Type of Request
Keynote
Panel
Plenary
Welcome/Closing Remarks
Talking Points
Hearing/Testimony/Media Event
Other:
Clear selection
Targeted Audience for the Event (For example: business leaders, community leaders, college students, faculty, teachers, etc.)
Your answer
Subject or Focus of the Talk
Your answer
Suggested Length of the Talk
Your answer
Potential Audience Size
*
25 or less
26 - 50
51 - 75
100 or more
Other:
Provisions (Honorarium, Accommodations, Travel, etc.)
Your answer
Organization Website/ Social Media Handles:
*
Your answer
Any special guest expected at the event or significant mentions (If so please provide additional details):
*
Your answer
Additional Information Dr. V should should know?
Your answer
Thank you for contacting me. I look forward to partnering with you. With confidence, Dr. V
Send me a copy of my responses.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms