Full Name

Company Name

Address

Suite

City

State + Zip Code

Email Address

Office Number

Cell Phone

Organization Type Organization TypeConferenceCorporateEducational InstituteNon-ProfitNon-Profit (Religious)Private (Personal Event)Small Business

Company Website

Social Media Pages

Event Name / Project / Client

Purpose + Type Of Event

Venue

Venue Address

Event Website

Event Date(s)

Event Time (Start + End Times)

Presentation Topic

Number of Presentations Requested

Presentation Duration Presentation Duration15 Minutes30 Minutes45 Minutes1 Hour1 Hour+Half Day (4-hours)Full Day (*-hours)

Presentation Time (Start + End Time)

Attendee Demographics

Planned Attendee Attendance Planned Attendee AttendanceUnder 250250 - 500500 - 1K1K - 2K2K - 3K3K - Plus

Projected Budget for Securing Services Projected Budget for Securing Services$500 - 1K$1K - $2K$2K - $5K$5K - $10K

Is this event open to the public?

Will tickets be sold for this event? (If yes, please provide ticket link.)

Are products being sold at this event?

Are you purchasing books for event attendees? (If so, how many?)

Will this event be recorded or live streamed?

What marketing materials will Bailey have inclusion?

How did you hear about Bailey?

Do you have any special requests or any additional information you would like to provide us?