Speaker Request

Event Details:

Name of organization:
Organization website:
Event name:
Event date:
Event time:
Virtual platform for event:
Time commitment (Does the speaker need to stay for the full event?):
Check-In date:
Check-In time:

Type of request: KeynotePresenterPanelistOther

Who are you requesting to speak at your event: Travis Michael FlemingKevin R. O’Brien
Who will be introducing the speaker?

If your requested speaker is unavailable would you consider another Apollos Watered speaker?: YesNo
Explain:

What costs should Apollos Watered anticipate for this event? RegistrationHotelTravelOther
Other:

What is the expected audience size?:
What is the attire?

Are there any safety considerations we should be aware of? YesNo
If Yes, please explain:

Will the event be recorded? YesNo
Is media expected? YesNo

How is your organization promoting this event? NewsletterNewspaperSocial MediaWebsiteOther
Other:

Any other relevant event information not included above:

Your Organization:

How does your organization align with our mission?

Include social media handles or hashtags relevant to the organization/event:

Primary point of contact for event details:
Name:
Title:
Mobile Number:
Email Address:

Speaking Related Items:

Speaking Time (include date(s) for multiple day events & length of message/panel):

What items do you need from us & in what format? Speaker's BioSpeaker's HeadshotSpeaker's TopicPresentationVisual AidesVideo ContentCompany Profile

File Format(s) Needed:

Due date for items requested:

Are there any special audio/visual capabilities we need to be prepared for? YesNo

If Yes, please explain:

Is Tech Support available? YesNo

What items are available? Wireless MicWired Mic Podium/StandPodiumOther
Other:

Please email event agenda & any other marketing materials to eliana@apolloswatered.org. If these are not yet available, when are they anticipated:

Provide an attendee list, speaker bios and list of sponsors. If these are not yet available, when are they anticipated?

Provide a map of venue, highlighting the place where the speaker will be speaking. If this is not yet available, when is a map anticipated?