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. Question Title * Contact Information: (Required.) Main Point Of Contact Company Email Address Phone Number Question Title * Name of the Event (Required.) Question Title * Where is the event located? (Required.) Question Title * What is the start DATE and TIME of the event? Date / Time Date Time AM/PM - AM PM Question Title * What is the end DATE and TIME of the event? Date / Time Date Time AM/PM - AM PM Question Title * Website of the event? Question Title * What organizations are sponsoring the event? Question Title * What is the vision and purpose of the event? Question Title * How many people are expected to attend? Question Title * Is this event open to the public or a private event? Question Title * Who is the target audience? Question Title * Will Sean be the primary speaker? Yes No Question Title * If any, who are the other speakers at the event? Question Title * How many sessions during the event are you requesting Sean to speak at? Question Title * What is the duration of each session time? Question Title * Will the talk be recorded and will we have access to it afterwards? Yes No Question Title * What is the name of the event venue? Question Title * Where will the event take place? Address Address 2 City/Town State/Province ZIP/Postal Code Country Question Title * Which airport should Sean fly into? Question Title * When do you expect Sean to arrive? Date / Time Date Time AM/PM - AM PM Question Title * When would Sean be available to return home? Date / Time Date Time AM/PM - AM PM Question Title * Will your event be covering all travel expenses? (Airfair, Hotel, Food, etc.) Question Title * Are you able to cover travel expenses for a companion? Yes No Other (please specify) Question Title * Is Sean responsible for booking travel arrangements? Yes No Other (please specify) Question Title * To whom will reimbursements be submitted? Question Title * Is this a paid speaking request? Yes No Other (please specify) Question Title * Will Sean be promoting his products and services at your event? Question Title * When do you need a final commitment from Sean? Date / Time Date Question Title * What information from Sean will you need to delivered prior to the event? Question Title * How did you hear about Sean Cannell? Question Title * Additional Comments/Questions Submit Speaking Request