GEMS Speaking Engagement Request Form

SPEAKING ENGAGEMENT REQUEST FORM

In order to help our team quickly respond to your request please answer the following questions.
Name*

First NameLast Name
E-mail*
Phone Number*

Area CodePhone Number
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Select your business request

Key Note AddressIndustry Related ConferenceVirtual SeminarYoung Adult Seminar
Topic
Example" How to Innovate in Time of Crisis"
Length of presentation
Example: 1 hour total with 10min Q & A
Session Date & Time*

MonthDayYearHourMinutesAM/PM Option
Event Venue
Example: The Pointe, Nassau, Bahamas
Number of People in Session*
Policies

1. Holding Dates: Because of the numerous inquiries we receive, and our desire to serve clients with an immediate answer, we do not hold dates. If the Letter of Agreement is not returned in one week the date will not be secured.

2. Cancellation: If this agreement is canceled by the group, the following schedule of percent of fee will be refunable and calculated from the time written notification is received at the office of Ms. Storr. Any expenses incurred and nonrefundable for travel will be due in full.
30 days or more before engagement 100%
29-15 days before 75%
14-7 days before 50%
6 or less days 25%

Ms. Storr has never canceled an engagement, been late, or failed to appear for an engagement. If Ms. Storr cancels speaking at your event for any unforseen reason(s), you will be sent a full refund of your payment.

If materials were purchased for participants, you will have the option to keep the materials, as they are nonrefundable.

3. Postponement: If the engagement is postponed, and notice is received in 14 days or more 100% of the deposit will be applied to the new date less any nonrefundable travel expenses incurred. If the amount does not cover non- refundable expenses the balance will be billed and due. If notice is received in less than 13 days, 25% of fee will be forfeited and balance applied to new date. There is no fee penalty for events rescheduled within 30 days following postponement.

If materials were purchased for participants, you will have the option to keep the materials and/or the materials will be avaialable for the new date.

4. Recording: The fee quoted is based on the fact that there will be no audio or visual recordings made of the presentation. Permission for the audio and/or visual recordings, for non-commercial use, must be made through Ms. Storr and a charge will be assessed accordingly.

5. Magnetic Success Coaches reserve the rights to have a video team present to cover the presentation on our behalf.

6. Room Set Up: The set up is the client's reponsibility. Our office will request and provide details on the best and preferred set up for the specific event.
Should be Empty:

SPEAKING ENGAGEMENT REQUEST FORM