Speaker Request Form - Felena Hanson

Requesting Organization*
Type of Organization*
- For Profit
- Non Profit
Type of Event*
URL for Event*
Location of Event. (Note if it's virtual)*
Address of Event
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Topic*
Date of Event*
MM slash DD slash YYYY
Time of Event (in Pacific Time)*

: Hours

Minutes

AM/PM
Time Speaker would Speak (in Pacific Time)*

: Hours

Minutes

AM/PM
Length of Talk*
Expected Attendance - number*
Profile of Attendees*
Authorizing Party Name*
Authorizing Party Title*
Primary Contact (if different from authorizer)
Phone*
Email*
Additional Terms:
This is an invitation, not a contract.

Speaking Fees
Small non-profit entities anywhere INSIDE of the 48 contiguous United States - $3,000 - $5,000.

For-profit entities, large nonprofit orgs, national / international conventions, etc. INSIDE of the contiguous 48 United States - $6,000-$8,000.

For-profit entities, large nonprofit orgs, national / international conventions, etc. OUTSIDE the contiguous 48 United States - $9,000-$15,000.

Half day training rate - $7,500 / Full day training rate - $12,000.

The requesting organization provides air travel, hotel accommodations, and meals, if applicable.
In circumstances where the requesting party seeks a partial or full waiver of any speaking fees, please note your extenuating circumstances here:
Name
This field is for validation purposes and should be left unchanged.

Speaker Request Form – Felena Hanson