Speakers Bureau Request Form

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Speakers Bureau Request Form


CONTACT INFORMATION
* Contact Person:
* Contact's Email address:
* Contact's Phone Number:
Contact's Fax Number:
EVENT INFORMATION
* 1. Group/Sponsor:
* 2. Event Name:
* 3. Event Location:
* 4. Date of Event:
* 5. Time of Event:
* 6. Recurrence:
* 7. Speech topic:
* 8. Purpose of event:
* 9. Number of Attendees expected:
* 10. Audience Demography:
* 11. Length of Presentation (in minutes):
* 12. Agenda Topics:
* 13. Will there be a Q & A aftwerwards:	YesNo
* 14. Presentation method requested:
* 15. Audio Visual Equipment Provided by Requestor:
* 16. Is a bio needed for speaker introductions?	YesNo
* 17. Send a copy of PowerPoint or handouts in advance?	YesNo
18. What is the organization's web address?
19. Comments
Verification Code:

Hartsfield-Jackson Atlanta International Airport