Request a Speaker

Your Details

Full Name (required)

Company (required)

Job Role

Please enter your email address: (required)

Please enter a contact number:

Is your company an current corporate partner of Richard House Children’s Hospice? (required)

Your Event

Please select the date of your event (required)

Please enter timings for your event, if known:

Please tell us a little about your event; including number of attendees, event audience, any objectives you have for the event, etc. the event (required)

Please provide the address for the location of the event if known, or alternatively planned location, e.g. The City. (required)

Who from Richard House would you like to attend your event? (required)

Corporate Partnerships TeamCEOHead of CareCare TeamFamily of Richard HouseTrustee or PatronsCorporate Partner

Please provide a brief overview of what you would like the Richard House representative to do, e.g. speech, demonstration (care), activity (such as Christmas lights switch-on). (required)

Thank you for completing this form. A member of the Corporate Partnerships Team will get back to you within two working days to discuss your request.

Thank you for your support of Richard House!

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