Yes, I’m interested in inviting Carmen to speak at my organization!

Please fill out the form below completely.

We’ll call you to schedule a get-acquainted call during which we can learn more about your needs and design a program that will help your organization achieve its goals.


Name:
Email Address:
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Title:
Organization:
City:
State:
Type of organization: Company

School, College or University

Non-Profit Organization

Government Agency

Other

If you decided to hire Carmen to speak, approximately when would the event take place? 1 - 3 months from now

4 - 6 months from now

7 - 12 months from now

Not sure

Besides yourself, who else would be involved in the decision to invite Carmen to speak?

How did you hear about New Demographic? Check ALL that apply. I've seen Carmen speak before

I read about Carmen in the media

A friend or colleague told me about it

I stumbled across it while searching online

Racialicious

Addicted to Race

Race in the Workplace

Anti-Racist Parent

Link on another blog or Web site

Other or not sure