SPEAKING ENGAGEMENT REQUEST FORM

SPEAKING ENGAGEMENT REQUEST FORM

Please complete and submit this brief questionnaire.
SPEAKING ENGAGEMENT REQUEST FORM

Organizations booking KCarl benefit from an unforgettable, enlightening and motivational experience. His keynote speeches and “keynote training” are done in a TED Talk format─passionate, informative, empowering, entertaining, and meaningful. To make his talks more personal, KCarl does not use a podium, which can be a barrier and hold a speaker at bay.

The nation’s #1 diversity engagement strategist and best-selling author, KCarl is the master of tailoring his keynote to meet your vision outcome.

Thank you for your inquiry into KCarl’s availability for your event. Don’t hesitate to call our office if you have any questions, 205-312-9985.

KCarl requires the following:
- A round-trip flight from Birmingham, AL (BHM), for more than 250 miles away...
- A product table with two chairs --- to sell his engagement resources
- The speaking fee starts at $8,000, with an advance payment of 50% required to confirm the event. Please contact us to discuss potential negotiations.
- Travel and lodging expenses are separate and not included in the speaking fee.
- 1-king size bed hotel accommodations
1. General Information
Today's Date:*

MonthDayYear
Requesting Organization:*
Organization's Mission:
Contact Name:*
Contact Title:
Contact Email Address:*
example@example.com
Contact Phone #*

Area CodePhone Number
Organization’s Website:
Date and Time of Event:

MonthDayYear
DateHourMinutesAM/PM Option
Name of Venue:
Venue Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
2. Type of Request:*
3. Subject / Main Focus of Talk:*
4. Does the event take place during a Conference/Meeting?*

YesNo
If yes, please identify the event:
5. Is event open to public or invite only?*
6. Will there be a fee to attend the conference?

YesNo
7. Potential audience size:*
8. Audience type:
Customize audience type:
9. Will the media be in attendance?*

YesNo
10. What additional details should we know?
Should be Empty:

SPEAKING ENGAGEMENT REQUEST FORM

1. General Information