Request a Speaker for Your Event

* Indicates required questions
Thank you for considering Strategic Growth Concepts' team to speak at your upcoming event. Please complete the form below to help us learn about your group/company, your event, and to determine your areas of interest. Please note that some of our speaker's require compensation to participate; we will discuss options when we speak with you directly. Additionally, our speakers are located throughout the U.S. and may or may not be willing/available to travel. The questions below will help us evaluate the most suitable speaker for your event.
Name *
First Last
Company Name *
Job Title *
Work Phone # *
Mobile Phone # *
Email *
What is the name of the organization/company that is requesting a speaker? *
What is the date/time of the event for which a speaker is required? *
What is the EXACT location of the venue where your event will be held (name of the venue, street address, city, state, zip)? *
Who will be attending this event (ie: franchisors, franchisees, engineers, sales people, marketing staff, all members of our company, our clients, etc.)? Please give as much descriptive information as possible. *
On what topic are you interested in having us present? *
How much time will be allocated for this presentation? *
Is your organization/firm willing to pay a speaker's honorarium? *
Yes No
Is your organization/firm willing to pay a speaker's travel fees (air travel and/or car rental, hotel, meals)? *
Yes No
Will you be able to provide technical support for the speaker's presentation? *
Yes No
Will you be recording this presentation by audio or video? *
Yes No
Will this presentation be posted online for listening/viewing after the event? *
Yes No
If this presentation will be posted online, will listeners/viewers be charged to hear/view the presentation?
Yes No
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