Speaking
Mental Health in the Workplace
Women’s Equity
Workshops
Coaching
Couples Coaching
Executive Coaching
Values Inventory
Masterclasses
Books
Press
Blog
Let’s Talk
✕
Interested in hiring Dr. Robin to speak?
"
*
" indicates required fields
Name
*
First
Last
Email
*
Phone
*
Organization Hosting/ Sponsoring the Event
*
Organization's Website
What is your role for this event?
*
In-house employee / event-coordinator
Contracted or consulting event-planner
Speaker’s bureau or agency
Other
Event Start Date
*
MM slash DD slash YYYY
Date Robin will speak
*
MM slash DD slash YYYY
Location of the Event
*
Event Format
*
Virtual, live event
Virtual, pre-recorded event
Live, in-person event
Recorded, in-studio
Other
Event Venue Address
*
Street Address
Address Line 2
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Speaking Role
*
Keynote (45 mins)
Panel member
Panel moderator
Breakout session (45 mins)
Executive summit (5-20 attendees, 2 hours to half day)
Emcee / host for 1-3 hour event
Emcee / host for full-day event
Emcee / host for 2+ days
Other
Anticipated Attendance or Registration
*
Less than 50
50-150
150-300
300-500
More than 500
Audience Description
*
Topic/ Theme for the Event
*
Speaker Budget
*
$5,000-$10,000
$10,000-$15,000
$15,000-$20,000
More than $20,000
Other important details we should know
How did you hear about Robin Buckley?
*
CAPTCHA
Name
This field is for validation purposes and should be left unchanged.
