Speaking Request

To Book Dr. Patty Ann Tublin to Speak at your next Event or Inquire about Availability
Please Fill out the Form Below

Interested in Booking Dr. Patty Ann Tublin for Your Next Event?

Contact Name*
First Last
Contact Email*
Company or Organization Name*
Contact Phone Number*
Best time to contact you
Budget for Speaker*
Date of Event*
Date and Time of Keynote, as well as requested arrival and departure times
Location of Event*
Venue, City & State
What is the expected attendance?*
Who was your speaker last year?*
What would Dr. Patty Ann’s role in the event be?*
Provide a detailed description of the event, and the attendees
Tell us more about the objectives of this event:*
Do you have a theme for the event? What is it and what is its significance to you and/or your organization?
What is the biggest challenge your organization and the attendees have that may not be addressed?*
How did you hear about Dr. Patty Ann Tublin?*
Google search? Referred by? A website? Whom can we thank?