Event Details

 

Thanks for taking the time to complete this form, so we can learn more about your event! Grant is very excited to work with you!

    Event Sponsor/Organization

    Contact Name

    Contact Position/Title

    Contact Email

    Contact Birthday

    Sponsor Address, City, State, Zip

    Mobile Number

    Work Number

    Home Number

    Date of Your Event

    Name and Address of Event Location

    Select Type of Venue

    If Other, Please Describe

    Event Name

    Event Theme

    If we could do anything to contribute to the success of your event, what would it be?:

    Event Contact Person

    Event Contact's Phone Number(s)

    Number of Times Speaking

    Name(s) of Talks

    Name(s) of Talks 2

    Name(s) of Talks 3

    Speaking Time(s) and Length of Talk(s). If this is for a conference, please note the session times.

    Dress Code

    Name(s) of Other Speaker(s)

    Audience Demographics

    Approximate Projected Attendance

    Speaking Details

    Necessary Arrival Date

    Arrival City/Airport

    Time by Which Speaker Must Arrive

    Departure Date/Time

    Lodging Details (Note: If host is responsible for Grant's hotel accommodations, please note details: Name, address, confirmation #)

    Special Requests/Information

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