Speaker series form – The Pink Agenda

Our Speaker Series brings inspiring stories and important conversations about breast cancer research, advocacy, and awareness directly to your organization. Please complete the form below to help us learn more about your group and how we can best tailor the experience for your audience. A member of our team will follow up with you shortly.

Company or Organization Name*

Name of Group Within Company (If applicable)

Contact Name

Contact Email*

Contact Phone Number

Dates of Interest

From

Preferred Session Time(s)

Would you prefer the presentation to be in person or virtual? *Note: Speakers are primarily located in the Northeast and Chicago areas
In PersonVirtual

If you chose “in person” above, please list your location.

Estimated Number of Attendees*

Please advise us if there are any goals for the event/areas of interest or focus:

Do you have any questions about The Pink Agenda Speaker Series?

How did you learn about TPA’s Speaker Series?

Would you like information on group fundraising for breast cancer research within your organization?

Yes! Please email me about how we can support TPA!Not at this time, thank you.

Thank you for your interest in The Pink Agenda’s Speaker Series!