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Conscious Dynamics®
Requesting an Event or Programs

Arranging an Event or Programs for a Group or Organization

Please complete this form keeping in mind that the likelihood of successful scheduling increases with the number of dates you can consider for your event.

When the preliminary process is completed and arrangements agreed upon, we will request a hardcopy summary statement on the letterhead of your organization to formalize the plan. This serves as our contract and provides us with necessary contact information. No engagement is final until Mary has responded to the hardcopy request.

Name:  

Title:     

Email:   


Sponsoring group or institution (contact information)


Event and event dates (include optional dates or rough time periods)

Where will the event take place? What city, state, or country? Please describe.
In a corporate environment, an hotel, church, school,auditorium, retreat venue, a home?


Describe the expected audience

What is your intended outcome? What is your primary purpose or theme?

Why you specifically contacting us - Mary Rees and Conscious Dynamics?

Details on honorarium.
(Please offer something which is both just and comparable. Include room and board
in a private setting, safe local transportation.)