Speaker Request Form

If you cannot meet our standard $3,000 speaking fee, enter what you are able to offer, and we will consider it. Be aware that preference is given to venues that can meet the standard amount. Also, be aware that the standard fee includes a full day of speaking, meaning that you can coordinate with other organizations to have our speaker speak at more than one event, and share the expense.

Your Name (required)

Your Email (required)

Subject

Speaker Requested (required)

Honorarium Offered (required)

Expenses you are willing to pay

Is there booth space at this event (required) YesNo

Location of Event (required)

Airport Speakers will fly to (if applicable) (required)

Event Name (required)

Number of years you have held this event (required)

Event Date and Time (required)