DR. CYNTHIA SANDERS
DEFINING WHO I AM. DEFINING ME WITH PURPOSE.
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Contact Person
Prefix
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Mr.
Ms.
Mrs.
Dr.
Prof.
Name
Organization
Title
Full Address
Telephone
Mobile Number
E-mail Address
Executive Assistant's E-mail Address
Social Media Handle or Website
Please provide a brief description in paragraph format below (maximum 150 words):
Please attach if possible, your ministry/organization program agenda, mission for this event request.
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Presentation Details
Event/Conference Title:
Sub-topics: Please provide between 3-5 bullet points outlining the main points/ issues/ "take-aways" for this event.
Could you please provide the names of any partners and or additional organizations that will be attending event/conference.
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Final Few Questions
Will this conference require closed meetings, group, or on a one to one sessions?
Yes
No
Not Applicable
Will taking part in/lead any interactive sessions such as roundtable discussions, meet the panelist etc.:
Yes
No
Not Applicable
Will there be any vendor sales opportunities such as books, workshops, etc?
Yes
No
Not Applicable
Event/Conference Flyer
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Any special inquires or notes?
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