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Christie Taylor

Speaker Inquiry Form

Public Speaker + Moderator/Panelist + Trainer/Facilitator

Contact Name

Position/Title

Company Name

Date of Event

Time of Event

Event Type

Event Title

Event Theme

What service are you interested in booking ?

If speaker, select your option.

Speaking Topic(s)/Presentation(s)

Presentation Delivered

Length of Presentation Time

Street Address

Street Address Line 2

City

Postal / Zip code

Region/State/Province

Country

Multiple Presentations Needed?

Phone

Fax

Website

Please specify parking location in proximity to building

If the event is in a Hotel or Conference Center, what is the name of the ballroom or conference room?

Audience Size

What audio-visual equipment is available?

Handheld microphone

Lavalier microphone

Teleprompter

Flip Chart

Screen

Computer

Projector

Smart TV

DVD Player

Whiteboard

Vendor table available for book/product sales? *

Yes, we will provide a vendor table

No, a vendor table is not available

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

Internet access available? *

Yes, WiFi is available

Yes, an ethernet cord is required

No, internet access is not availble

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

Yes, it will be filmed.

No, it will not be filmed.

Interested in purchasing books/products for audience? *

Yes, we are interested

Not at this time

Onsite event contact name and cell phone number?

What is your budget for this presentation?

What are the guidelines for travel budget and arrangements?

Additional Information

Thanks for submitting your Speaker Inquiry!

After review, we will be in touch to discuss your submission and the steps forward.

If you have any additional questions, please send an email to christie@christietaylorconsulting.com

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Christie Taylor Consulting specializes in NAICS codes: 541613 for marketing consulting, 541820 for public relations, 611430 for professional development, and 611699 for all other miscellaneous schools/instruction.

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Christie Taylor

Speaker Inquiry Form

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