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Presentation Request Form
Request from an agency, organization, employer, school for a presentation or webinar on ADHD
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* Indicates required question
CADDAC offers presentations or webinars at a cost.
The cost will be based:
1. Length of presentation: per hour; half day ; or full day
2. Delivery Method: Virtual (cost will be determined by #of participants); In person (travel and
expenses extra)
3. Existing or Individualized Presentation
Agency, Organization, Employer or School making the request
*
Your answer
Name of person making the request, and job title
*
Your answer
Contact information (email, phone number, name of person if not the same as person making the request)
*
Your answer
Date(s) requested for presentation
*
MM
/
DD
/
YYYY
Time, length and audience size
*
Your answer
Method preferred ( live or virtual)
*
Live
Virtual - Zoom
Virtual- Teams
Description of subject matter
*
Your answer
We are able and willing to cover the fee
Yes
No
Maybe
Clear selection
We are ready to book the presentation or need more information
Yes
No
Need a call back before moving forward
Clear selection
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