Speaker Request Form

Speaker Request Form

All booking requests must be processed through this form. Provide as much detail as possible about your event, speaker preferences, and contact information.
Host Organization*
Person of Contact*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Event Information
Event Name*
Event Topic*
In-Person LiveOnline LivePre-Recorded
Which speaker are you requesting?*
Role Requested*
Type of Event*
Amount of time required*
This is the full length of time the speaker is expected to log on or be present for.
Venue Address (if in person)*

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Tell us more about your event*
Include any other details that were not mentioned above.
How did you hear about us?*
Honorarium

Honorarium for in-person events starts at $250CAD. Online events are billed every 15 minutes. Pro-bono requests will be considered in the order they are received.
Honorarium Amount and Details*
I understand
The event is within the GTAThe event is onlineWe will be covering travel and accomodation
Should be Empty: