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Presentations

Breast Health Presentations

Susan G. Komen® Austin offers a network of volunteers we call a Speakers Bureau. Komen Austin has trained this core group of skilled and enthusiastic speakers who are ready to spread the word about the fight against breast cancer through FREE breast health presentations in English and Spanish.

To request a free Breast Health Presentation for your corporate or community group in Bastrop, Caldwell, Hays, Travis or Williamson counties in Texas please fill out the survey below at least 2 weeks in advance. Questions? Email emay@komenaustin.org.

*1.

Question - Required - First and Last Name (include title, suffix, professional suffix if applicable):

*2.

Question - Required - Email:

*3.

Question - Required - Phone Number with area code:

*4.

Question - Required - Organization/Company Requesting Presentation:

*5.

Question - Required - Address of Company/Organization requesting presentation:

*6.

Question - Required - Are you the point of contact for this event? Yes
No

Question - Not Required - If you are not the point of contact, please provide that person's name, phone number and email:

*8.

Question - Required - Date (1st choice). At minimum must be two weeks from today:

Month

Day

Year

Question - Not Required - Date (2nd choice):

Month

Day

Year

*10.

Question - Required - Time to Begin:

*11.

Question - Required - Proposed Length of Presentation:

*12.

Question - Required - Proposed Focus of Presentation:

*13.

Question - Required - Expected Attendees:

*14.

Question - Required - % Female

*15.

Question - Required - % Male

*16.

Question - Required - Age Range of Attendees:

*17.

Question - Required - Language Preferred: English
Spanish
Billingual English and Spanish
Other Language Needed (note in comments)

18.

Question - Not Required - Additional Comments:

Austin Affiliate of Susan G. Komen®
P.O. Box 2164, Austin, TX 78768 · Phone: 512-473-0900· Fax: 512-473-0999 · Email: info@komenaustin.org

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