Please complete this form to submit a speaking request for Dr. LaQuandra S. Nesbitt. Name Email Address Onsite Event Point of Contact Onsite Event Point of Contact Cell Phone Event Description (Include event title and intended audience.) Number of attendees Location Type Conference Class Lecture Opening/Closing Remarks Panel Other… Enter other… Is this event open to the media? Yes No Other… Enter other… Event Date Event Start Time Speaker's Presentation Time Presentation Run Time Is there anything else we need to know? Examples may include: requested materials (slide decks, bios) and due dates, agendas, travel information, etc. CAPTCHA Math question 9 + 1 = Solve this simple math problem and enter the result. E.g. for 1+3, enter 4. This question is for testing whether or not you are a human visitor and to prevent automated spam submissions. Submit Leave this field blank
