Presentation Booking Form - Country Road Chats

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Contact Doreen: +1-403-741-2367 | countryroadchats@gmail.com

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CLIENT INFORMATION:

Company or Organization Name:

Contact Name:

Phone Number:

Email:

Mailing Address:

PRESENTATION DETAILS:
Presentation Title:

Date:

Time:

Venue Address:

Any Special Instructions?: door entrancemeeting place
EQUIPMENT
Project with AudioClient will Supply
Paper Flip ChartClient will Supply

Number of Participants expected to attend:
Gender of Participants: MaleFemale

EXPENSES (if applicable): Mileage cost: YesNo Mileage charge per kilometer $0.55

Accomodations: YesN/A
Meals: YesN/A

SPECIAL CONCERNS OR OTHER INFORMATION: How did you hear about my presentations?: Please enter your name as your signature: Date Signed:

Check to confirm and sign all the information filled in above
I confirm the above is correct: Yes

PLEASE NOTE: YOUR PRESENTATION WILL NOT BE BOOKED UNTIL THIS FORM IS FILLED AND RETURNED.

Thank you for booking a Country Road Chats presentation! I look forward to our time together!

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