ENQUIRE ABOUT HAVING CAMILITA AS YOUR SPEAKER THANK YOU FOR REQUESTING CAMILITA TO SPEAK AT YOUR EVENT To adequately address your speaking needs, we ask that you complete the following questionnaire with as much information as possible. Please return this questionnaire along with any materials for review as soon as possible as Camilita’s calendar fills up very quickly. GROUP & EVENT INFORMATIONName of the Event:*Date(s) of the event:*Website:*Event Location(s):*Event Type:*Event Size:*Event Audience:*Speakers Budget (including airfare and hotel):*Event session needs:*Keynote1-2 Day WorkshopFull Day WorkshopContact Person* First Name Last Name Email* Enter Email Confirm Email Phone* FURTHER EVENT DETAILSOnly fill in what applies to you......1. Do you have a Speaking or Conference theme? Please state here:2. What is your strategic objective for Camilita Speaking?3. What sensitive issues should be avoided?4. Time frame of presentation (e.g. 10am-12pm):*5. How will payment be made for having Camilita as your speaker?*6. What comes immediately before and after Camilita’s presentation?7. Who are the other speakers on the program (if any) and what are they talking about?8. What professional speakers have you used in the past?*9. What did you like or dislike about their presentations?10. Is this a specialised group or general public? If specialised, please explain details11. Please list (3) three things Camilita should know before addressing your group:*12. What are some of the most significant events that have occurred in your industry, organisation or business this year?13. Audience demographics:Percentage of men:Percentage of women:Average age of group:Average income of group:General description of attendees:14. What is the goal for your audience? (the most important question)*15. Please provide a brief description of your organisation:*16. Are you happy to give a recommendation once the speaking event is completed?17. Please provide any other relevant information you think we should have..... This iframe contains the logic required to handle Ajax powered Gravity Forms.