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Name*

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Speaking Topic*

Event Date*

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Event Location Name*

Event Address

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Multiple Presentations Needed

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Audience Size

Describe the Audience. What do they do?

What are their challenges?

What do They Need to Learn/Take Away from this Session?

What A/V Equipment is Available?

Will you Film the Event?

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Is there Internet Access Available?

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Is there a Vendor Table Available for Books/Products Sales?

Yes

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Are You Interested in Purchasing Books for the Audience?

Yes

No

What is Your Budget for this Presentation?

What are the Guidelines for Travel Budget and Arrangements? (Should we book the travel or will your company handle that?)

Additional Information

Book Dr. Goodbinder