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Contact Form for Booking Bureau Speakers

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Fill out the form below. It will be submitted to the Spearker's Bureau Coordinator. Your request will be processed and contact with the requested speaker will be established. The details of your contract will be worked out between the two parties. Level 2 speaker contracts are $500 unless otherwise negotiated by the two parties.

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Booking Requestion Form

Name: Telephone #:
Address: E-Mail:
City, State:      Zipcode       

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Speaker's Name: Date Submitted
Program Topic: Event Date:
Presentation:

Briefly summerize the program event: WHO? (Group/Person making the request) WHAT? (Nature of the speaking engagement) WHEN? (What date is this event) WHERE? (What is the location and time of this event). If you have a question, it can be entered here.

Summary:
    

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Contact the Kansas State Council:
E-mail: WEBMASTER
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