Speaking Requests

General Information

I can be available for speaking, hosting, or emcee (mc) opportunities - but I need some information.

* = required

Name of Organization*

Name of Contact Person*

Contact Person's Email*

Assistant's Name

Assistant's Email

Contact Phone Number*

Speaking or Emcee Information

Event Name*

Date of Event*

Multiple Dates

Purpose of Event*

Length of Session (45 min, 75 min, 8 hrs, etc.)*

Speaking Topic or Emcee*

Estimated Number in Attendance*

Audience Profile (Leaders, Pastors, Students, Harlequins, etc*

Attire*

Typical Budgeted Honorarium for This Event*

Previous Speakers at Your Event*

Additional Notes

Travel Information

Location and Address of Event Site*

Distance From Airport to Speaking Location*

Verification - Enter the text in the box, then press send.*
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