City Council President Mary Sheffield Speaker Intake Form

City Council President

Mary Sheffield

Speaker Intake Form

Date*

Contact First Name*

Contact Last Name*

Name of Company or Event*

Phone Number*

Email Address*

Date of Event*

Time of Event*

Event Address*

Speaking Topic*

Please provide three talkings points you would like President Sheffield to touch on during her speaking engagement.*

Length of Presentation Time*

Audience Size*

Audience Age Range*

Honararium?*

Onsite event contact name*

Onsite event contact cell phone number*

Any other additional notes or information about the event.*

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