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Please fill out the following form and click Send at the bottom of the page to submit. If you have any materials or ideas for this lecture, please mail or fax our press coordinator, Ms. Takahashi, for more details.
We will respond as soon as we have reviewed the application

Please contact Ms. Takahashi for more details
press@ewoman.co.jp
Phone: 03-5766-7800
Fax: 03-5766-7801
Request for Lecture or Speech
Event Name
Sponsor
Event Time Month Day Year( - (Total: minutes
Time Required Month Day Year( - (Total: minutes
Location
Nearest station
minutes on foot by car
from station
 
Company Name Contact Person
e-mail Tel
Desired Speaker Kaori Sasaki / Other Fax
How do you know us?
 
Objective of Event
Desired Topic
Format Lecture/ Panel member/ Panel Coordinator/ Other
Other Presenters
Event Agenda
Attendee Data Number of people Average age  Male/Female ratio  Field/Position
Is a slide projector available? (for PPT presentation) Yes/ No Can promotional literature be distributed? Yes/ No
 
Will you be taking photos, shooting video or recording audio? Yes /  No
Will you be making posters, fliers, or advertisements for this speech? Yes /  No
Will the content of the speech be made available afterward? Yes /  No
Will we be able to confirm the content of the speech before publishing?
※Please note that we retain all re-publication rights for the speech.
Yes /  No
 
Can information about ewoman be distributed? Yes/ No
 
Lecture Fee To be paid
Not paid
Yen
(Not including consumption tax or other fees)
Bill to:
Comments
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