Initial Contact Form

By providing the following information, we can contact you to possibly secure the date for your event. Please provide detailed information as it will help us in coordination and booking of dates. Michael has the goal of making sure that he provides adequate time to your event.

Michael's current corporate engagement fee is $650.00 plus expenses. Church and non profit organizations are booked on an honorarium plus actual expenses.

Please provide the following contact information:

Name

Title

Organization

Street Address

Address (cont.)

City

State/Province

Zip/Postal Code

Country

Work Phone

Home Phone

FAX

E-mail

URL

Enter the date of the event :

-- dd/mm/yy

Enter the time of the event :

-- hh:mm:ss am/pm

What role do you wish Michael Pate to do for your event?

Master of Ceromonies
Keynote Speaker
Motivational Speaker
Inspirational Speaker
Informational Speaker
Other

What are your goals for the event!

How long will the speaker be required to speak?

How many people will be in attendance

Describe the Venue that event will be held in.

Will Michael Pate be required to do any press or interviews before arriving for the event or after the event.

Will you be promoting the event and if so how?

Name
Title
Organization
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone
Home Phone
FAX
E-mail
URL

Initial Contact Form

When Big Boys TriCopyright © 2004 When Big Boys Tri . All rights reserved. Revised: 01/02/06

When Big Boys Tri
Copyright © 2004 When Big Boys Tri . All rights reserved.
Revised: 01/02/06