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
Contact First Name
Contact Last Name
Contact Phone Nubmer
Event Name
Organization Name
Event Date
Event Start Time
Event End Time
Event Location Street Address
Event Location City
Event Location State
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
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Cathy's RolePlease describe the expectations you have of Cathy for the event (brief remarks, keynote address, workshop, etc.)
0 /
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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