Karine Sokpoh Speaking Request

Contact and Organization information

Provide information about you and your organization.

First Name

Last Name

Phone

I am able to enter into a contract regarding this speaker on behalf of myself or my organization.

Yes

N/A

Other

Please explain

Name of organization submitting request

This event is

For Profit

Nonprofit

Other

Please explain

Event Details

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Event type

Event Date and Time

Event Location

Event purpose/goal

Website(s) that support your event or video request (If you do not have a website, enter "NA.")

Presentation/Speech Details

Requested topic

Estimated Duration

If this is a presentation, will the remarks be followed by a Q&A?

Yes

Will media be present at the event?

Yes

Will the presentation be repurposed, in any way, at any time, as on-demand content?

Yes

Presentation format

Audience Details

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Approximate size of the expected audience

If this is a presentation, list the names and titles of expected honorable guests

Is membership required to attend the event?

Yes

Additional Information

Details about speaker compensation and deadlines.

Deadline for the requested speaker to accept / decline the request

I am the point-of-contact for information about rates / compensation related to this speaker (if applicable).

Yes

Please enter person's name

I understand this speaker may charge a fee, and that subsequent conversations about this speaker may include discussions about compensation. I equally understand this speaker may choose to waive any potential fee, and subsequent conversations may include this possibility / choice, as well.

Yes

My event is either nonprofit, education-related or volunteer, and I would like to discuss a fee-waiver for my event, if this speaker charges a fee.

Yes

Other

Please explain

FOR EVENT PLANNERS ONLY: Cost to attend the event (Include all pricing levels and benefits)

Additional questions or comments