Meeting Planners Contact Form Thank you for your interest in having Speakers Plus! assist you in booking a professional speaker for your event. We need your basic contact and event details so that we can begin to collaborate with you. Please complete the form below. Remember to click the "Send the Request" button when you have completed the form. Alternatively, you can download either a Word or Adobe Acrobat form, and send back as an e-mail attachment to info@speakersplus.com or fax to 757-547-5753. Use whatever format is most convenient for you. You and Your Organization Name: E-mail: Organization: Title: Mailing Address: Office Phone: Cell Phone: FAX: Best Time to Call: Weekday mornings Weekday afternoons Other (Please specify) About Your Event Name of Event: Topic Requested: Type of Event: Professional Development Association Meeting/Event Sales Conference Fundraiser Executive Retreat/Planning Sports/Adventure/Teambuilding Other (Please specify) Location (City/State): Date of Event: Speaker Budget: $20,000 and above $10,000 to $20,000 $5,000 to $10,000 Below $5,000 Unknown Exact Budget: Additional Remarks:

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