SPEAKER REQUEST

If you are interested in having Corwin and/or Kim Anthony speak at your event, please complete and submit the following information about your event. Or you can also mail the information to:

Athletes in Action
P.O. Box 551748
Ft. Lauderdale, FL 33355

We appreciate your interest and cooperation!

Name:

Organization:

Phone Number:

Email Address:

Website:

Organization Description:

Event Description:

Event Date:

Location:

Topic/Theme:

Length of Talk:

Target Audience:

Men Women Youth Other