Speaking Requests

Speaking Opportunities

Richard is available for speaking engagements, corporate talks, and events

Copy and paste the following form and email it back to us at hortness@gmail.com and we will get back to you within 2 business days.

 

SPEAKING REQUEST FORM

Company Name & Address:

__________________________________________________________________________________

__________________________________________________________________________________

Main Contact Information:

Name: ____________________________________________________________________________

Position:_____________________________________ Phone: _______________________________

Fax:_________________________________________ E-Mail:_______________________________

Event / Appearance Information:

Type of Event: _____________________________________________________________________

Date of Event: ______________________________________________________________________

Location of Event: ___________________________________________________________________

Language of Event:  □ French   □ English   □ Bilingual

Type of Appearance:   □ Speech □ Client Event □ Cocktail Party □ Breakfast / Luncheon

Start of Event: ________ AM / PM (please circle)   End of Event: _________ AM / PM (please circle)

Specific Goals & Purpose of Event:

__________________________________________________________________________________

__________________________________________________________________________________

__________________________________________________________________________________

Attire: __________________________________________________________________________________

Speaking Fee Budget: 

□ 500 - $1,000    □ $1,000 - $1,500    □ $1,500 - $2,000   □ $2,000+

Please fill out the form and email back to hortness@gmail.com

Thank you for the opportunity to work with you.  You will be contacted directly within 2 business days to discuss your speaking requirements.