GSAE Speaker Suggestion Form 2013

1. Proposed Session Details

Our members are always on the lookout for locally-based speakers who can provide an entertaining keynote – motivational, inspirational, topical – just about anything good and worthwhile.

Please respond with your best suggestions - include the topic, speaker, contact info, etc.

As a thank you for your time, I’ll compile the recommendations within 10 days and send them back out for y’all’s records.

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* 1. Speaker Suggestion Contact Information

Name

Company/Organization

Phone Number (if available)

Website

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* 2. Please provide the title/subject(s) the speaker offers.

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* 3. Please indicate a fee range if known. Check any that apply.

Unknown

No fee

Travel Expenses Only

Less than $2500

$2500-$5000

$5000 - $10,000

$10,000 and up

Question Title

* 1. Speaker Suggestion Contact Information

Question Title

* 2. Please provide the title/subject(s) the speaker offers.

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* 3. Please indicate a fee range if known. Check any that apply.

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* 4. Comments or recommendation regarding speaker suggested.