Nushape Publication
Resources to Improve Your Outlook & Direction in Life
Request for Rashun Jones RN MHR To Speak
"The Attitude Adjuster"

Please take time to fill out the questionnaire so that Rashun can tailor her message to your specific needs.  In addition, please send any printed information relative to your company or organization.  Fill out this questionnaire at least 4 weeks in advance of your program.
The Organization
Name:
Address:       
City, State, Zip:
Contact Person:
Phone:
Fax:
Email:
Type of Organiztion:
Mission/Goals
The Event
Type of Event:
Date of Event:
Audience: (type & size)
Location of Event:
Venue:
The Presentation
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Proposed Honorarium:
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Questions & Answers:
Type of Presentation:

(click one or more please)
Can Rashun's books
be sold.
Official PayPal Seal
Keynote
Workshop
Luncheon Speaker
Dinner Speaker
Plenary
Moderator
Other
YesNo
YesNo