Would you like Debrena to speak at your next event?

If your organization, group, college, or company is seeking a dynamic, engaging speaker, for an upcoming event, Debrena Jackson Gandy could be the perfect fit! She provides custom-tailored, transformational keynotes presentations, seminars and workshops.

If you are with a business or corporation, would you like to receive one of Debrena's corporate presentation brochures? If so, please indicate this in the bottom of this form in the "Additional comments" section, and include your name and complete mailing address

Please fill out the form below, press the SUBMIT button and Twanda Hill, Debrena's Speaking Coordinator will contact you within 2 business days. Ms. Hill may also be reached at 206-248-6072.

*Indicates a required field. Please also assure you mark the best way to contact you (i.e., phone, fax, e-mail).

Company/Association/Organization:

Your Name*:

Your title:

What is your role in planning this event: Program Coordinator Group Member Committee Member Interested Individual

Address:

City:

State:                Zip:

Day Phone:           Evening Phone:

Fax Number:           Your Email*:

Requested Date and Time:

Group to be spoken to:

Number of attendees:

Type of speaking event: Keynote Signature Workshop Retreat Panel Other Please select one

What is your speaker budget amount/range at this event:

How would you like us to respond? Please check one.
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