Kim Ford Speaker/Host Request From
Thank you for your interest in having Kim Ford speak at your upcoming event. In order to help us facilitate your request, please complete and submit the following form at your earliest convenience.
Speaking at North Clayton High School - Fly Girls Rock Panel
Red Carpet Reel
Today's Date
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Name of the organization submitting the request *
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Company URL *
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Contact Name *
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Title *
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Email address *
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Phone *
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Event Name *
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Event URL (if applicable)
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Event Date *
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City, State *
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Event Start Time *
Time
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Event End Time *
Time
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Speaker time required at event *
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Venue
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Event Environment *
Theme *
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Goal *
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Ticket Price(s) *
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Expected Audience Size *
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Audience Demographics *
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Confirmed Speakers (if applicable)
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Past Speakers (if applicable)
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Confirmation Deadline *
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Will there be a step and repeat red carpet? *
Will media be invited to attend this event? *
Please detail any requests for social promotion *
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What is your speaker budget Ms. Ford? *
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Is travel and hotel assistance provided separately from the speaker budget? *
Type of Presentation *
Length of Speaking Time *
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Topic of Presentation *
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