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Speaking Engagements

Contact Name

Name of Company or Event




Mailing Address

Speaking Topic

Date and Time of Event

Event Location (city, state, and hotel/venue)

Length of Presentation Time

Multiple Presentations Needed?

Audience Size

Describe the audience. What do they do? What are their challenges? What do they want to learn/take away from this session?

A/V equipment available?

Will you film the event? (If so, request a copy)

Internet access available?

Vendor table available for book/product sales?

Interested in purchasing books for audience?

What is your budget for this presentation?