Requesting Dr. Crawford to Speak Question Title * 1. Type of Event Luncheon Evening Weekend Retreat Conference other OK Question Title * 2. Approximate number of attendees OK Question Title * 3. Type of group Business group/organization Church group/organization Non-profit group/organization Networking group/organization TV interview Online (i.e. podcast interview) Other OK Question Title * 4. The setting/location in which the talk will take place OK Question Title * 5. Date and length of talk OK Question Title * 6. Objectives you would like to see come from the talk. OK Question Title * 7. Budget for the speaker? And if there is significant travel for Dr. Crawford to get to your event, what is your budget for her travel expenses? OK Question Title * 8. Your contact information Name Company Address Address 2 City/Town State/Province -- select state -- AL AlabamaAK AlaskaAS American SamoaAZ ArizonaAR ArkansasCA CaliforniaCO ColoradoCT ConnecticutDE DelawareDC District of ColumbiaFM Federated States of MicronesiaFL FloridaGA GeorgiaGU GuamHI HawaiiID IdahoIL IllinoisIN IndianaIA IowaKS KansasKY KentuckyLA LouisianaME MaineMH Marshall IslandsMD MarylandMA MassachusettsMI MichiganMN MinnesotaMS MississippiMO MissouriMT MontanaNE NebraskaNV NevadaNH New HampshireNJ New JerseyNM New MexicoNY New YorkNC North CarolinaND North DakotaMP Northern Mariana IslandsOH OhioOK OklahomaOR OregonPW PalauPA PennsylvaniaPR Puerto RicoRI Rhode IslandSC South CarolinaSD South DakotaTN TennesseeTX TexasUT UtahVT VermontVI Virgin IslandsVA VirginiaWA WashingtonWV West VirginiaWI WisconsinWY Wyoming ZIP/Postal Code Country Email Address Phone Number OK Question Title * 9. Please share anything else you would like Dr. Crawford to know. OK DONE