We are not accepting new talent at this time Thank You QUESTIONAIRE QUESTIONNAIRE Your name as you would wish it to be listed on the website:* First Last Email* Phone*Address* Street Address City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Website* References: Provide three (3) references. We will not accept the questionnaire if left blank.* Facebook URL: Include # of Followers Linkedin URL: Include # of Connections Twitter URL: Include # of Connections Instagram URL: Include # of Connections Youtube URL: Include # of Subscribers SPEAKERS: Your Net Fee for a keynote, full-day, half-day, virtual presentation, and domestic vs international SPEAKERS: (1) Provide no more than three (3) of your Signature Keynotes: (2) with a brief description, (3) and 3-5 take-a-ways for each. List your most popular presentation first.SPEAKERS: How will you challenge your audience?ENTERTAINERS & CELEBRITIES: What is your specialty? I.e., musician, actor, voiceover actor, singer, etc.INFLUENCERS: What is your specialty? What endorsements do you seek?Share something interesting about yourself.*Provide a link to your demo video of at least 4-5 minutes in length in front of a live audience. Remove the venue logo and any contact information; as these will not be accepted.*Tell us your story. What is working for you and where do you need help? What are your 3-5 year goals?*Your Biography: (100 wds)*Where will you be traveling from?* What language(s) do you speak fluently?* AUTHORS & PODCASTERS: Provide Sample Books, Products, & Show RecordingsList of Clients From the Past Two Years. Include speaking gigs, endorsements, TV, motion picture, & Podcast appearances:*The following documents are required to help us make our decision to represent you. If the following marketing assets are not available, our brand team will work with you to develop high quality marketing assets (for a fee).High-res headshot*Max. file size: 100 MB.Current Media/Press Kit*Max. file size: 100 MB.Speaker One-Sheet (Helpful, but not mandatory, if you have a solid speaker website)Max. file size: 100 MB.Attach a copy of your W-9Max. file size: 100 MB.How did you hear about us? Advertisement Social Site Web Search Friend/Colleague Other reCaptcha