Speaking Request For Carina Gardner, Ph.D.

Full Name *

Name of Company/Organization making the request *

Phone *

Email *

Event Name and Description *

Is the Event Virtual or In person? *

Virtual

In Person

Location of Event (city, state, country, venue name)

Enter the event website if you have one

Expected number of attendees *

What date(s) is your event? *

Describe who the audience will be at the event *

What is the audience expecting or needing from attending this event? *

What Topic Do You Want Carina to Discuss

Duration of Presentation *

How did you hear of Carina Gardner? *

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**A member from Carina Gardner Team will contact you with information on Carina's Availability for this request