Speakers Bureau District 30 Toastmasters Speaker Feedback

District 30 Toastmasters Speakers Bureau
Request A Speaker

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Feedback on Speakers

Requesting a Speaker is as simple as "A-B-C!" (Items in RED are required.)
Section A	Requestor's Contact Information
Name
E-mail Address
Phone - Day (Include AC)
Phone - Evening (Include AC)
Fax (Include AC)
Address (If different than what you will enter in "Section B")

Section B	Location of Event Details
Address 1
Address 2
Building Number (If applicable)
Room Name/Number
City
State
Zip Code
Type of Organization (If "Special Interest" or "Other," please detail further in "Section C, Additional Comments.")

Section C	The Event Information
Date On Which Event Will Be Held (Month, Day, Year)
Time Event Begins	Time: --
Estimated Attendance
Topical Area of Presentation Sought (Check all that would be acceptable. Provide additioanl information in "Additioanl Comments" in this section if needed.)	Business Etiquette Career Transition Change Management Communication Educational/Informational Humorous/Entertaining Inspirational Leadership Life Balance Motivation/Achievement Personal Development Public Speaking Team Building Stress Management
Attire
Theme/Purpose
Type of Event
Type of Presentation
Which of the following will be avaliable at no charge for the speaker's use? (Check all that apply.)	Microphone Lectern Screen Overhead Projector PC/Laptop Projector Whiteboard TV/VCR Cassette Player Desktop/Laptop-IBM Desktop/Laptop-MAC None
Specially Invited Guest, Dignitary, Office Holder, etc.
Additional Comments and Information

	8-15-2005

Speakers Bureau Chair
Marguerite O'Connor, ATM-B

Please note: Speaking engagements negotiated directly between your organization and the speaker, without the services of the District 30 Taostmastrers Speakers Bureau management, may require compensation for the speaker.

Certificates, letters of appreciation, or any means to document a speakers appearance before your organization is encouraged.

After hosting one of our speakers, please promptly return the feedback form provided by the speaker or go online and complete the Feedback on Speakers form . This helps ensure the highest quality service to the community.