Guest Speaker Booking Form

Guest Speaker Booking Form

Speaker Name:

Contact Details:

(please include office mailing address, email address, phone, fax and day-of event contact numbers)

Speaker’s Assistant and/or Booking Agent Contact Details:

(please provide full name, email address, phone and fax numbers)

Event/Conference:

Appearance Date & Time:

Venue:

Presentation Title/Topic:

Presentation Timeline (advance prep time/Q&A session):

Fee:

Expenses:

Note: If expenses include accommodation and transportation please indicate that here (also indicate who will be responsible for making these arrangements). List hotel room type and any other applicable needs if requesting the Conference Planning Committee to make these arrangements. CAIS is a non-profit organization and has established a policy that it will reimburse speakers for economy based fares only. Please provide original receipts/invoices for payment via the CAIS office.

Payment Details:

Technical Requirements:

Special Instructions:

Recording Permission:

Canadian Accredited Independent Schools (CAIS) requests the presentation given by the above-mentioned speaker be digitally recorded, videotaped and/or audio taped for the purpose of posting on the organization’s website for its membership.

I, <insert speaker name> give permission for my presentation to be recorded and used on the CAIS website for viewing by the organization’s membership.

______

Guest Speaker’s SignatureDate

I, <insert speaker name> do not give permission for my presentation to be recorded and used on the CAIS website for viewing by the organization’s membership.

______

Guest Speaker’s SignatureDate

Event Details:

Audience will consist of the following groups:

□ Heads of Schools□ Board Members□ Academic Leaders

□ Primary School Teachers□ Junior/Middle School Teachers□ Senior School Teachers

□ Business Officers□ Advancement Officers□ Admissions Officers

□ Administrative Staff□ Parents□ Students

□ Partners/Spouses

Speaker attire:

Business attire/business casual

Audience attire:

Will range from business attire to business casual

Book Selling/Signing Opportunity:

If applicable, please provide us with the necessary details.

Accepted by Guest Speaker:

______

Signature of Speaker and/or Officer Authorized to sign and bind the contractDate

______

Print Name of Person signing aboveTitle/Position

Accepted by CAIS <insert name of conference> Conference Planning Committee Chair

______

Signature of Chair to sign and bind the contractDate

______

Print Name of Person signing aboveTitle/Position