Speaker Request Form - Crystal Kirch
I am honored to be considered to present at your upcoming Professional Development event. It is my goal that teachers are informed, equipped, and empowered to find ways to enhance and improve the teaching and learning in their classrooms.

Please complete the form below to request a speaking quote for me to present at your Professional Development. I will follow up with you via email within a week's time.

Name
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Job Title
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Organization
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Address
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Telephone Number
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Email Address
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Proposed Date(s) and Time(s) of Professional Development
Please include Time Zone
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Preferred Duration of Professional Development
(in hours)
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Approximate Budget for Event
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Number of expected participants
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Description of expected audience
(subject, grade level, experience level)
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Background knowledge (including previous trainings) of participants
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Topic(s) of Professional Development
What do you want the teachers to learn, practice, and understand by the end of the training? Below is a list of trainings I have done in the past. I am open to new requests for trainings; please provide me as detailed of a description of your needs as possible. All trainings listed below are between 1-3 hours each.
Additional Comments or Questions
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