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lpaige17

Jul 8, 20202 min read

A Model For Success

Have you ever worked on a project and didn't quite know where to start? After serious research, you discover a template that allows you...

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Contact Information

First name

Are you the point of contact? If not list the point of contact name.

Business or Organization Name:

Last name

Phone

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Event Details

Event Name

Event Time

Event Purpose

Which day(s) will the event take place?

Desired speaking date (subject to availability and confirmation)

Brief event description and/or date range if multiple days are requested:

Is this a recorded event?

Yes

How many days will the event tak place?

Single Day

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Is this an in-person, virtual, or hybrid event?

In-Person

Virtual

Hybrid

Is there any fee for attendance?

Yes

Audience & Venue Details

Audience Size

Invitation Only or Open to public?

Invitation-Only

Open to public

Event Location

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School Auditorium

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Sanctuary

Home

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Do you have AV available? (projector, handheld, headset or lavelier mic, corded or cordless?

Select all additional items the speaker needs to bring:

Speaking Table

Extension Cord

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Speakers

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No additional equipment will be needed

Do you have Wi-Fi access?

Yes

Other things the speaker needs to bring:

What is the amount of time allocated for the speaker? (e.g., 20 minutes, 1 hr, 3 hrs).

Will the speaker need to be present for the entire event?

Yes

Presentation/Speech Details

Type of Presentation

Estimated speaking time (e.g., 20 min., 90 min., 3 hrs.)

Select the topic(s) of interest

Effective Communication

Building Trust

Roles & Blindspots

Relationships & Finances

Difficult Conversations

Temperaments & Talent

Relationship Boundaries

Affair Proof Marriage

Other

Is the topic fixed or flexible?

Flexible

Fixed

Do you already have a program or an agenda?

Yes

Briefly describe the desired outcome or other topics of interest if different from above:

Thank you! We’ll be in touch.

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