KEYNOTE – Bert Oliva

Keynote Request Form

Name(required)

Phone(required)

Email(required)

Speaking Topic(required)

Date of Event(required)

Specify Time of Event (eg: 7:00PM)(required)

Event Location Name(required)

Event Location/Address(required)

Length of Presentation Needed?(required)

Multiple Presentations Needed?(required)

Audience Size(required)

Describe the Audience. What do they do?(required)

What are their challenges?(required)

What do they need to learn/take away from this session?(required)

A/V Equipment Available?(required)

Will you film the event? (If so, we request you do not film Bert.)(required)

Internet access available?(required)

Vendor table available for books/products sales?(required)

Interested in purchasing books for audience?(required)

What is your budget for this presentation?(required)

What are the guidelines for travel budget and arrangements? Should I book the travel or will your company handle that?(required)

Additional Information