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Speaking Request - Dorothy Burton
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Organization Name
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Contact Name
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Contact Phone
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Contact Email
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Contact Address
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Organization Website
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Event Name
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Event Location
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Event Date
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Brief Description of Event
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Number of Guests Expected
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Who is the target audience?
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Is your event:
select one
Faith-based
Non Faith-bsed
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How long would you like Dorothy to speak?
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Additional speakers at the event
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Is there a topic you would like Dorothy to address?
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Will event be recorded?
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Are airfare, mileage, lodging and meals included?
select one
Yes
No
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Are you able to cover travel expenses for an assistant?
select one
Yes
No
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Is an honorarium provided?
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Yes
No
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Will you provide a master-quality, digital audio and video recording (if applicable) of Dorothy's presentation to use at her discretion?
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Are there any other additional requests associated with event?
Social Commitments
Interviews
Meetings
Meet and Greet
Other
None
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