Speaker Request Form

Thank you for your interest in having Questar III District Superintendent Dr. Gladys I. Cruz speak at your event. To check on her availability, please complete the following form at least eight weeks before your event. We highly recommend submitting your request as far in advance of your event as possible. Please note that it is not possible to accommodate all invitations due to the large number of requests we receive. Her assistant Janet Sawyer will contact you to notify you of Dr. Cruz’s availability. Thank you.

Requester Information

Name(Required)

Event Information

MM slash DD slash YYYY
Start Time of Event(Required)
:
End Time of Event(Required)
:
What Time Will Gladys Speak(Required)
:
Location/Address(Required)

Audience Information

Engagement/Presentation Information

Please Indicate the Type of Engagement Being Requested(Required)
Will There Be a Question-And-Answer Session to Follow?(Required)
Is Your Organization Paying for Any Expenses to Attend Your Event, Such as Registration, Travel or Lodging Fees?(Required)

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