Reach Out for an Impactful Experience (352) 575-2438 [email protected] "*" indicates required fields Name*Organization*Title*Phone Number*Please format your phone number with the area code in brackets (***)Email Address* Dates you are interested in having Dr. Bird speak? please pick 2 or 3 choicesFirst Date Preference* MM slash DD slash YYYY Pick your optimal date Second Date Preference MM slash DD slash YYYY Pick another dateThird Date preference MM slash DD slash YYYY Pick one moreCheck all that apply Keynote Workshop Full Day Conference Staff Development Day Webinar How can Dr. Bird help you?Who is your audience and what are your goals?Event location and number of attendees?NameThis field is for validation purposes and should be left unchanged. Δ
