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Steven Smith
Home
Store
Invite to Speak
Excerpts & Outlines
Interviews
Biography | CV
Contact
Invite to Speak
Please fill out the form below and we will contact you regarding your request.
Name
*
First Name
Last Name
Phone
*
(###)
###
####
Email Address
*
Location of Event and Venue Name
*
Starting Date of Event
*
MM
DD
YYYY
Ending Date of Event
*
MM
DD
YYYY
Proposed Number of Presentations
*
Presentation Info
*
For each presentation list the following: (1) The Proposed Topic; (2) The Desired Duration of Time for Each Presentation; (3) What Time of Day the Presentation Will Take Place
Select
*
We will offer Dr. Smith an honorarium
We are requesting a donation of Dr. Smith's services
Amount of Proposed Honorarium (if applicable)
Number of Speakers
*
Dr. Smith will be the sole speaker/presenter at this event
There will be other speakers/presenters at this event
Anticipated Attendance
*
How Will This Event Be Advertised (If applicable)
Method of Attending
This is a free event
Admission will be charged
Cost of Admission (if applicable)
Type of Event
*
This is a not-for-profit event
This is a for-profit
This is a fundraising event
Name of Charity (if this is a fundraising event)
We Can Provide a Volunteer to Assist at Dr. Smith's Media Table During the Event
Yes
No
Proposed Lodging
*
Enter Hotel, Rectory, or other applicable lodging.
Travel Arrangements Will Require which of the Following?
No overnights on location
One overnight on location
Two overnights on location
More than two overnights on location
This is Part of an On-Going Series
*
Yes
No
If Part of an On-Going Series, Please describe
Thank you!