Event Information Form

So that we may better match your requirements with appropriate professionals please complete the following as completely as possible.
Thank you.

Organization:

Contact Person:

Title:

Address:

City:

Province/State:

Pc/Zip:

Country:

Telephone:

Facsimile:

E-mail:

Website:

Invoice Address:

Other Key People:

Who Will Make the Selection Decision:

No. Attending:

Description of Attendees:

Event 1

Date of Event (dd/mm/yy):

Presentation Time From:

To:

Event 2

Date of Event (dd/mm/yy):

Presentation Time From:

To:

Event 3

Date of Event (dd/mm/yy):

Presentation Time From:

To:

Event 4

Date of Event (dd/mm/yy):

Presentation Time From:

To:

Location of the Event: 

What is the theme or topic for your event?

What speaker topics are you interested in?

Are you looking for any particular speaker(s)?

Will there be other speakers?

What is your budget for speakers?

Are you negotiating with any speakers, agents, or other bureaus?
Yes No

Who?

What type of information do you require, if available?
Press Kit Demo Tape Video One Sheet Promo References
Fee Schedule A.S.B. Info

Please make any additional comments below that would help us with recognizing your requirements so that we may better serve you.