Invite Us to Speak

Organization Name*

Name*

Phone

Email

Street Address

City, State, Zip

Website

Title of Event

Date of Event

Time of Event

Location of Event

Type of Event

Topic (if applicable)

Presentation Length

Anticipated Audience Size

Anticipated Audience Type

(please check every group that you think will make up at least half of the audience)

Student group
Health professionals
Grand Rounds residents
Birth professionals

Will your organization cover travel expenses outside NYC? (transportation, hotel room, food)

Yes
No

Honorarium

A donation is appreciated but not required for trainings and speaking engagements. Please let us know how much you can offer to support Choices in Childbirth’s mission to help women make informed decisions about where, how and with whom to birth and ensure that they have access to the full range of birth options. We are always happy to discuss reduced fees based on need.

$500 (gov’t agencies, colleges/universities, businesses)
$250 (non-profits, community or student groups, high schools)

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