NEALE DANIHER AO APPEARANCE REQUEST FORM

Question Title

* 1. Organisation name?

Question Title

* 2. Organisation Contact Name? (Name, Email and Phone number)

Question Title

* 3. What kind of event is this for?

Fundraiser/Charity

Corporate

Professional

Awareness

School Visit

Other (please specify)

Question Title

* 4. The purpose of the proposed event?

Motivational

Informative

Leadership

Staff Engagement

Health & Wellness

Other (please specify)

Question Title

* 5. What will the Alumni’s role be at the event?

Keynote Speaker

Panel Member

Q&A session

Fireside Chats (format between MC & Speaker)

Other (please specify)

Question Title

* 6. Due to Neale’s medical condition, it may be difficult for him to attend all events in person. As such, is virtual attendance (video message, Skype/Teams) possible?

Yes

Question Title

* 7. Is a representative acceptable if the Alumni is not able to attend in person, such as Bec or Jan Daniher?

Yes

Question Title

* 8. How big is the audience?

Less than 20

21-50

50-100

Over 200

Other (please specify)

Question Title

* 9. Will you cover flights, accommodation, and travel expenses? (if required)

Yes

Other (please specify)

Question Title

* 10. How long would you like the Alumni to attend?

Up to 1 hour

Up to 2 hours

Up to 4 hours

Other (please specify)

Question Title

* 11. Will you pay a speaker's fee if requested?

Yes

Other (please specify)

NEALE DANIHER AO APPEARANCE REQUEST FORM

Question Title

* 1. Organisation name?

Question Title

* 2. Organisation Contact Name? (Name, Email and Phone number)

Question Title

* 3. What kind of event is this for?

Question Title

* 4. The purpose of the proposed event?

Question Title

* 5. What will the Alumni’s role be at the event?

Question Title

* 6. Due to Neale’s medical condition, it may be difficult for him to attend all events in person. As such, is virtual attendance (video message, Skype/Teams) possible?

Question Title

* 7. Is a representative acceptable if the Alumni is not able to attend in person, such as Bec or Jan Daniher?

Question Title

* 8. How big is the audience?

Question Title

* 9. Will you cover flights, accommodation, and travel expenses? (if required)

Question Title

* 10. How long would you like the Alumni to attend?

Question Title

* 11. Will you pay a speaker's fee if requested?

Question Title

* 12. Is there anything else you would like us to consider in reviewing this request?