People for Education - Speaker Booking 2017-2018
Name of Speaker being requested: *
Date of Event: *
MM
/
DD
/
YYYY
Time of Event: *
What time is the speaker scheduled to speak?
Time
:
Topic: *
What will the speaker be talking about? Please elaborate.
Your answer
Fee: *
Food, travel and accommodation (if applicable) are charged on top of the fee and will be included on the invoice.
Your answer
Format:
(keynote/panel/workshop/etc.)
Your answer
Other participants:
(if panel or workshop)
Your answer
Length of speech/panel/workshop: *
Please describe the length of time the speaker will be speaking
Your answer
Audience Size:
Approximate number of people attending
Your answer
Event location: *
Complete address
Your answer
Host: *
Name of group or organization hiring the People for Education speaker.
Your answer
Contact Name: *
Name from Host organization.
Your answer
Contact email address: *
Your answer
Contact phone number:
Your answer
Contact phone number on day of event: *
A cell phone # in case of emergency
Your answer
Travel arranged by: *
Accommodation organized by: *
Accommodation address (if applicable):
(If applicable and if arranged by Host organization>)
Your answer
Billing Name (If different than contact name):
Your answer
Billing address (email or mailing address):
We can send the invoice by email or hard copy.
Your answer
Filming and/or recording:
Will you be filming or recording the portion of the event that People for Education is participating in?
Additional notes:
Any other information we should have?
Your answer
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