Ken Brown Speaker Participation Agreement
Event Type:
Select One
Nonprofit
Youth Rally/School
University/College
Corporation
Trade Association
Expo/Convention
Conference
Church Event
Purpose of Appearance: (choose)
Keynote with Book signing (90 minutes)
Keynote Address (45-60 minutes)
Question and Answer (Q&A) Session (30-45 minutes)
Double_Block Booking (Negotiable)
(One or session in one or two days)
Requestor/Authorized Party
Name:
Title:
Host/Sponsorships/
Institutions:
Address:
City:
State:
Zip:
Email:
Department:
Other Contact:
Title:
Phone:
Fax:
Purpose of Appearance
Program Title:
Date
Start Time:
End Time:
Location:
Venue Type: (Hotel/Convention Center/Church, etc.)
Specific Start Time:
Specific Participation:
Promotional Interviews: (Print, TV and Radio)
PLEASE NOTE:
The Host/Sponsor cannot revise schedule after contract execution without the speakers written permission.
Audience Type
Target Audience:
Age Group(s):
Anticipated Audience Numbers:
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