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#BetterTogether

Thank you for your recent booking inquiry to retain
Dr. Deirtre Cotton.
Please be aware that this serves as an invitation only, this DOES NOT constitute a confirmation of appearance by Dr. Deirtre Cotton.
It will assist us in making the best decision possible while doing all we can to meet your request.

Organization Name

Organization Website

Organization Contact Name

Organization Contact Email

Organization Contact Phone

Organization Address

Event Title

Event Date

Event Address

Event Details (Please Include Theme, Purpose, Time, Etc.)

Speaker Details (Please include what you are requesting Dr. Deirtre Cotton to do at your event.)

Proposed Honorarium?

Submit