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SPEAKER REQUEST FORM "The Hibiscus King"

We appreciate your interest in inviting SHALOM BAKO "The Hibiscus King" to participate in your event. Kindly input the information required to enable us prepare accordingly. Share with us any materials 5 weeks prior to the event date.

A letter confirming receipt of your request will be emailed to you after submission.

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Speaking Topic(s)
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Required
Inviting Organization / Individual *
Description of organization
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Event Name
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Event Type?
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Target Audience *
Event Topic
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Event Description
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Event Start
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DD
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YYYY
Event End
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MM
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DD
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YYYY
Speaking Date

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DD
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YYYY
Deadline to receive speaker confirmation
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MM
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DD
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YYYY
Speaking Start Time
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MM
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DD
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YYYY
Event Time Zone
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Speaking Duration
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Q&A Duration
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Address Type

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Proposed Speaking Topic(s)
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Event Venue
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Event Country
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Audience Size
Clear selection
Please provide the names and titles of the other speakers/panelists
Are you expecting any distinguished guests at this event?
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Is an award, certificate, gift or other item being presented to the speaker?
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Do any promotional materials for the event include the speaker's name?
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WHOM TO CONTACT
Event Contact Name, Address, designation, email, phone number
Event Contact Name & Contact Information
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