Kevnesha's Booking Request

Name of Contact person

Name of Organization

Organization Website

Contact Email address

Number

Date(s) of Event

Times and Length of Event

Topics

Cannabis & Mental Health

Racial Trauma & PTSD

EMDR

Other

Please specify requested topic in additional topics

Speaker Participation Format

Training/ Workshop

Panel Discussion

Keynote speech

Conference

Other

Please specify in the comment section

Format of Event

In person

Online

Compensation/Reimbursement Rate for Speaker

Additional Comments