When I receive an inquiry from someone who wants to hire me as a speaker for their event, I go through a series of questions to make sure I understand the scope of the opportunity. This Speaker Intake Form helps me collect all of the data I need to move forward and meet expectations for an event. Feel free to copy the details below, modify them to fit your needs, and create your own form!

Speaker Intake Form:

Contact Name

Name of Company or Event

Phone

Email

Fax

Mailing Address

Speaking Topic

Date and Time of Event

Event Location (city, state, and hotel/venue)

Length of Presentation Time

Multiple Presentations Needed?

Audience Size

Describe the audience. What do they do? What are their challenges? What do they want to learn/take away from this session?

A/V equipment available?

Will you film the event? (If so, request a copy)

Internet access available?

Vendor table available for book/product sales?

Interested in purchasing books for audience?

What is your budget for this presentation?

What are the guidelines for travel budget and arrangements? Should I book the travel or will your company handle that?

Onsite event contact name and cell phone number?

Other Notes

Some Additional Considerations

You may want to ask if you can speak with several potential audience members prior to the event so that you can better understand their interests and needs. Also, speakers should collect a 50% deposit along with a signed contract in order to finalize arrangements for a speaking engagement. The balance due of 50% should be payable on or before the day of the event.

I’ll post a sample speaker contact soon. Stay tuned!