| | | | | |
ONECHILD EXPERT SPEAKER BOOKING FORM
* Denotes mandatory fields.
|
1. Which speaker are you looking to book?
|
|
| |
| |
2. In order to cover our administrative costs and ensure that all funds raised by young people benefit our international projects, we do ask for an honorarium in addition to any air and ground transportation, accommodations, meals, and incidental expenses.
|
| *Honorarium: | |
| |
| |
3. Presentation details
|
| *Type: | |
| *Date: | |
| Alt. Date: | |
| Time: | |
| Alt. Time: | |
| Length of Presentation: | |
| Venue Name: | |
| Presentation Room: | |
| Venue Address: | Street: | | City: |
|
| | Province/State: | |
Postal Code / Zip Code: |
|
| | Country: | |
| |
| |
4. Event details
|
| *Type of Event: | |
| Theme: | |
| Please describe the audience (number, age range, occupation): |
| |
| |
| |
5. Organization/School/Company
|
| *Name: | |
| *Address: | Street: | | City: |
|
| | Province/State: | |
Postal Code / Zip Code: |
|
| | Country: | |
| |
| |
6. Main contact
|
| *Name: | |
| Position: | |
| *Phone: | |
| Cell: | |
| Fax: | |
| *Email: | |
| |
| |
7. Media
|
| Are you inviting media? |
| Would you like the speaker to be available for interviews? |
| |
| |
8. Recording
|
| Would you like to video or audio tape the presentation? |
| * Recording any presentation and/or workshop will require consent from OneChild. We ask that a copy of your recording be sent to OneChild to use for our promotional purposes. |
| |
| |
9. Anything else you'd like us to know?
|
| |
| |
| |
Special Requirements
|
| Our speakers will require an LCD Projector, white screen, microphone, amplification for video played on laptop, cord to connect sound system to laptop. |
| |
| |
|
| |
