Speaking Engagement Request
If you or your organization would like to request Dorothy McDermott, MS, LPC_S, NCC to speak at your event then please complete this form.
If a question does not apply then enter "n/a" or if you have questions then just enter "question" and we can discuss it by phone.
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Name (First & Last) *
Email address *
Contact Phone Number *
Organization Name
Event Name *
Event Date *
Type of Event *
Location of Event (in-person)
Specific Topic Request *
What, if any, topic would you like me to discuss?
Length of Requested Talk *
Expected Number of People (in case I use activities) *
Demographic of audience members (male, female, teens, etc.) *
When considering the organization and attendees, what would make this talk a success?
What is your budget for this event?
Are you purchasing books or other materials from my store for audience members? *
*Will your organization cover travel & lodging expenses? *
If the location is more than a reasonable day's driving distance or if the event is later in the evening.
Will the event be professionally recorded? *
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