Event Request

To request Cathy to speak for your event, please fill out as much information as possible in the form below.

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1
Event Name
Organization Name
Event Date
Event Start Time
Event End Time
Event Location Street Address
Event Location City
Attire
Attire Details
Purpose of Event
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Audience DetailsWho will be attending? Are there any guests Cathy should be aware of?
0 /
Do you have a speaker/facilitator budget for this event?
Estimated Attendance
Is the Event Open to the Press?
Attending MediaPlease list names of any confirmed or expected media attending.
0 /
Livestream/OnlineWill the event be live-streamed or posted online?
Event POC First and Last Name
On-site POC First and Last NameIf main event POC will not be present, please provide an on-site POC.
Event SetupPlease describe how the event will look (head table, lectern, etc.).
0 /
Seating ArrangementsIndicate where Cathy will sit, who will be seated with her, etc.
0 /
A/V TechPlease describe the A/V setup
0 /
Cathy's RolePlease describe the expectations you have of Cathy for the event (brief remarks, keynote address, workshop, etc.)
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Cathy's IntroductionPlease tell us who will introduce Cathy (name, title, role, etc.)
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AgendaPlease provide the event agenda. NOTE: You may upload a PDF of the agenda below if that is more convenient.
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Agenda UploadUpload a PDF of the agenda if not providing it in the box above.
Upload PDF
Bio and HeadshotDo you need a bio and headshot of Cathy?
Additional InfoWhat other details does Cathy need to know about this event?
0 /

Please provide any additional documents (e.g., news articles, promo materials, etc.) via email: events@cathylewis.com.

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