Speaker Request Form

Please fill out this form to request Yvette to SPEAK at your event

Email *

Headliner/Host(s)/Organization *

Full Name *

Address

City *

State *

Phone *

Website *

Event Information

Event Location *

Event Date *

Event Name *

Event Start Time *

What day of the event will Yvette be presenting/selling? *

Event End Time *

What are the attendees paying to be present at this event? *

Are all the speakers pitching products? What prices? *

Will Yvette have additional obligations in order to participate? *

Who else is speaking? *

Do you have demographic/psychographic profiles or details on the audience? (age, income, business types, etc.) *

Event History: (continued) *

How many attendees were there?
What did they pay to attend?
How many speakers were there?
How many do you anticipate will attend this year?

Event History: (a) Have you done this event before? *

YES
NO
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What speaker expenses will you be paying (travel, hotel, class, meals, etc.)? *

Are you promoting the event and to how many people? *

What equipment is provided? *

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