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Speaker Request Form
Please fill out the form below in order to request Sean Cannell to speak at your event. We will reach out to you via email with a response.
*
Contact Information:
(Required.)
Main Point Of Contact
Company
Email Address
Phone Number
*
Name of the Event
(Required.)
*
Where is the event located?
(Required.)
What is the start DATE and TIME of the event?
Date / Time
Date
January
February
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December
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Hour
Time
:
Minutes
AM/PM
-
AM
PM
What is the end DATE and TIME of the event?
Date / Time
Date
January
February
March
April
May
June
July
August
September
October
November
December
1900
1901
1902
1903
1904
1905
1906
1907
1908
1909
1910
1911
1912
1913
1914
1915
1916
Su
Sunday
Mo
Monday
Tu
Tuesday
We
Wednesday
Th
Thursday
Fr
Friday
Sa
Saturday
01
02
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30
Hour
Time
:
Minutes
AM/PM
-
AM
PM
Website of the event?
What organizations are sponsoring the event?
What is the vision and purpose of the event?
How many people are expected to attend?
Is this event open to the public or a private event?
Who is the target audience?
Will Sean be the primary speaker?
Yes
No
If any, who are the other speakers at the event?
How many sessions during the event are you requesting Sean to speak at?
What is the duration of each session time?
Will the talk be recorded and will we have access to it afterwards?
Yes
No
What is the name of the event venue?
Where will the event take place?
Address
Address 2
City/Town
State/Province
ZIP/Postal Code
Country
Which airport should Sean fly into?
When do you expect Sean to arrive?
Date / Time
Date
January
February
March
April
May
June
July
August
September
October
November
December
1900
1901
1902
1903
1904
1905
1906
1907
1908
1909
1910
1911
1912
1913
1914
1915
1916
Su
Sunday
Mo
Monday
Tu
Tuesday
We
Wednesday
Th
Thursday
Fr
Friday
Sa
Saturday
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Hour
Time
:
Minutes
AM/PM
-
AM
PM
When would Sean be available to return home?
Date / Time
Date
January
February
March
April
May
June
July
August
September
October
November
December
1900
1901
1902
1903
1904
1905
1906
1907
1908
1909
1910
1911
1912
1913
1914
1915
1916
Su
Sunday
Mo
Monday
Tu
Tuesday
We
Wednesday
Th
Thursday
Fr
Friday
Sa
Saturday
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Hour
Time
:
Minutes
AM/PM
-
AM
PM
Will your event be covering all travel expenses? (Airfair, Hotel, Food, etc.)
Are you able to cover travel expenses for a companion?
Yes
No
Other (please specify)
Is Sean responsible for booking travel arrangements?
Yes
No
Other (please specify)
To whom will reimbursements be submitted?
Is this a paid speaking request?
Yes
No
Other (please specify)
Will Sean be promoting his products and services at your event?
When do you need a final commitment from Sean?
Date / Time
Date
January
February
March
April
May
June
July
August
September
October
November
December
1900
1901
1902
1903
1904
1905
1906
1907
1908
1909
1910
1911
1912
1913
1914
1915
1916
Su
Sunday
Mo
Monday
Tu
Tuesday
We
Wednesday
Th
Thursday
Fr
Friday
Sa
Saturday
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
What information from Sean will you need to delivered prior to the event?
How did you hear about Sean Cannell?
Additional Comments/Questions