Tiffany D. Cross Speaker Request Form
Thank you for your interest in having Tiffany participate in your event. Tiffany is represented by WME Entertainment. Please fill out the attached form and someone will get back to you within three business days with her fees and availability.

You may also contact WME Speakers:
info@wmespeakers.com
212.903.1400
www.wmespeakers.com.

What is the name of your organization? *
Your answer
Where will the event take place? *
Your answer
What date will Tiffany be needed? *
MM
/
DD
/
YYYY
What is the time block Tiffany will be needed? *
Time
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Is your organization providing travel and lodging? *
Will this event be broadcasts? *
How many attendees do you anticipate? *
Your answer
Who is the audience? *
Your answer
What role are you asking Tiffany to fill for the event? *
Who are the other confirmed speakers? *
Your answer
What is the stage format? (if applicable) *
Microphones *
Who is the single point of contact for the day of the event? Please provide a phone number and email address. *
Your answer
Any additional information Tiffany should know? *
Your answer
Tiffany D. Cross
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