Representation Questionnaire - TALENT CONCIERGE

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 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 Recordings

List 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-9

Max. file size: 100 MB.

How did you hear about us?

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Tell us about Yourself

QUESTIONNAIRE

QUESTIONNAIRE

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).