TALENT REQUEST FORM

Please take a few moments to fill out the form below, so that we can best prepare to serve you.

It's okay if you don't have all the details yet! We're also happy to help you fill in some of the blanks as you create your agenda.

Contact Information

First name*

Last name*

Email*

Phone number*

Company name*

How did you hear about The Talent Brokerage?*

Talent Request

Talent Name(s)*

Talent Request*

Keynote Speaker

Team Training

Brand Partnership

Interview / Fireside Chat

Moderator

Panel / Roundtable

Event Curation / Multiple Speakers

Budget ($USD) *

I understand that Talent expects coverage for travel, accommodations and transportation for all in-person requests.*

Event or Campaign Details

Event and/or Campaign Name*

Event Company or Brand Name*

Industry / Audience*

Event Date(s)*

Event Time / Time Frame*

Event Location(s)*

Audience Size*

This work will be...*

Virtual

In Person

Both

Topic(s) of Interest*

Please describe your audience in more detail, as well as the experience(s) you're hoping to provide. (It's okay if you don't have all of the details yet!) *

Are you interested in booking additional talent/speakers for this event/campaign?*

Yes

Is there anything else you think we should know?

Terms

By submitting this form, you agree to continue professional communication regarding this request with the Talent Brokerage on behalf of the talent being requested. All talent is subject to availability and alignment, and will not be guaranteed without separate written agreement.*