Brianna Henderson Booking Form

Booking Agreement

Complete form below to retain the services of Brianna D. Henderson
For Direct Inquiries contact the main representative at admins@letstalkppcm.org or call (214)-412-5378

*Rate is confirmed upon booking.
Your Name*

First NameLast Name
E-mail*
example@example.com
Phone*

Area CodePhone Number
Event Date & Time*

MonthDayYearHourMinutesAM/PM Option
We are booking Brianna for*
Name of Event*
Name of Venue
Venue Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Event Attire
Honorarium Pricing

Prices based on engagement length and do not include travel cost. Up to 50 participants=$25/per | Up to 100 participants=$25/per
Please select an option:*
prevnext( X )
Patient Advocate$30.00

Certified Family Partner$500.00

PPCM Screening Course$1,100.00

PPCM Workshop$1,250.00

Panel Discussion$2,000.00

Guest Speaker$3,500.00

Short Film Video Rental$3,600.00
12 month bundle.

Keynote Speaker$4,000.00

Total $0.00
Type a question

Other Arrangement (explain below)
Other Arrangement
A 50% Non-refundable retainer is required to guarantee speaking date.*

I will send a check made payable to Brianna Harris-HendersonEmail me an invoice via Paypal
Travel Arrangements
Please select an option*

This event is in Texas (in-person)This event is outside of Texas. (Email me a travel estimate.)Virtual event
Payment Terms

Please check to show your understanding and agreement with the terms below.
Confirm agreement by selecting both*

I agree to pay in full all financial obligations including travel expenses due to Brianna prior to event.I agree to make checks payable to Brianna Harris-Henderson
Terms of Agreement
Check to agree with terms*

This contract is for the personal services of Brianna Harris-Henderson made between you(“purchaser") for the event described. The speaker agrees to attend according to the terms and conditions listed. All information, data, and presentation shared is copyrighted and to not be used without LetsTalkPPCM permission.
Signature*

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Booking Agreement

Honorarium Pricing

Travel Arrangements

Payment Terms

Terms of Agreement