Presentation Information Request

Presentation Information Request
for Robert Prince, CST

Mr. Robert Prince, CST,
Author, Founder & CEO of SurgicalTechSuccess.com
is currently booking speaking engagements.

Mr. Prince is a seasoned veteran in the field of Surgical Technology
with an extremely successful career of 20+ years in & around the field of surgery.
Click here to read his complete bio.

If you would like to request information about booking Mr. Prince to speak
at your Surgical Tech School, Medical Facility, Career Day, or In-service,
fill out the information request form below.

Read testimonials submitted by attendees of past speaking engagements of
Robert Prince, CST.
Speaking Engagement Testimonials

Presentation - Request for Information

Please note that all fields followed by an asterisk must be filled in.

Name of School, Medical Facility, or Professional Organization, *

Your Position (Educator, Counselor, Director, etc)*

First Name*

Last Name*

E-Mail Address*

Street Address*

City*

State/Prov*

Zip/Postal Code*

Business Phone*

Fax

Status of Attendee's
(students, faculty, O.R. staff, potential students, etc)*

Number of expected attendee's*

	Less than 10
	10 - 20
	20 - 30
	30 - 40
	40 or more

When are you thinking about possibly booking Mr Prince?
(Month, Day, Year - Time frame may be an approximation- )*

Have you read or previewed the Surgical Tech Success Handbook?

	Yes
	No

Questions or Comments

Affirmation*

By checking this box, I affirm that all of the information I am submitting is true and accurate. Furthermore, I attest that I am an authorized representative of the aformentioned school, medical facility, or professional organization.

Presentation Information Request for Robert Prince, CST

Presentation - Request for Information

Presentation Information Request
for Robert Prince, CST