Speaking Request Form for Jeff Shinabarger
Are you interested in having Jeff speak for an event you're a part of? Fill out the speaker request form, and we'll be back to you as soon as we can.
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Jeff's TED talk
Date(s) of events
(i.e. June 17-18 2013)
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Time(s) of events
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City/State of Event
(i.e. Atlanta, GA
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Venue
(i.e. Georgia World Congress Center)
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Sponsoring Organization
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Who does this event primarily target?
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What is the projected size of the event?
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Who else is speaking at this event?
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Please describe the vision of your event and how you see Jeff Shinabarger fitting into the vision.
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How much time will Jeff have to share?
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At what time[s] would Jeff be speaking?
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What kind of media will Jeff be able to use while he's speaking
(i.e. Can he show a video, or have a powerpoint presentation?)
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Honorarium Proposed?
(i.e. $1500)
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How many of Jeff's books would you like to purchase?
[books come in case quantities of 24 at $10 per book.]
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Jeff often travels with a staff or family member. Would travel expenses and accommodations for one additional person fit within the event budget?
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What is the nearest airport?
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How did you hear about Jeff Shinabarger?
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Would you offer exhibiter/booth space for Gift Card Giver and Plywood People?
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Contact Person Name
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Email Address
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Address
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City, State, Zip
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Organization Phone Number
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Mobile Phone Number
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