Florida : 239-558-8343

Information Request

I am interested in the following speaker:
Please provide me with:

Speaker fees and availability / any other information needed..
Method of Delivery:
Please e-mail us information
Please call us with information
Please mail us information
In order to better serve you, would you
kindly tell us the purpose of your event and what you
would like the speaker to achieve? You may describe this in any length..
Length of Presentation:

Keynote: 45-90 minutes

Half Day: 2-3 hours

Full Day 3-6 hours

Contact Name:

Organization Name:

Mailing Address 1:

Mailing Address 2:




Date/dates of Event:

Location of Event:

Audience Size and Make

Closest Airport:

Phone Number:

Fax Number:

Email Address: * required