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Speaker bio and information long form

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Speaker bio and information long form

  1. 1. SPEAKER BIO AND INFORMATION FORM-Long Form Contact Information: Name: __________________________________________________________ Address: ____________________________City: ________ State: ____ Zip Code: ______ Email Address: ________________________ Cell Phone#: _________________________ Biographical Information: Short Bio: __________________________________________________________________ __________________________________________________________________ Complete Bio:__________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ Flight Information: Please make flight arrangements for me. Legal Name: _______________________________ DOB: ______________________ Departure Airport: __________________ Preferred Airline: __________________ Frequent Flyer # ________________________ (If Applicable) Passport Number: ________________Passport Expiration Date: ____________ Hotel Information: Please make hotel reservations for me Name as it appears on my ID: _______________________________ Preferred Hotel Chain: __________________ Frequent Traveler # ___________________
  2. 2. SPEAKER BIO AND INFORMATION FORM-Long Form Car Rental Information: Please make car rental reservations for me Name as it appears on my ID: _______________________________ DOB: ______________________ Driver’s License #: __________________ State: _______ Preferred Car Rental Company: __________________ Membership # _________________ AV Needs: Projector: Laptop: Microphone: (Type: _____________) Remote: ______________________ Other: ____________________________ I use: PC MAC Presentation Format: Keynote Powerpoint Handouts/Resources: Handouts: I will bring my own copies/handouts Please make copies for me Resources: Title: ______________________ Cost: _____________ Title: ______________________ Cost: _____________ Title: ______________________ Cost: _____________ Resource Set Up Needs: _______________________________________________________ Special Requests: (Dietary needs, allergies, or other special requests below) ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________

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