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Location

KANSAS LEADERSHIP CENTER

325 East Douglas Avenue
Wichita, Kansas 67202
Tel: 316.712.4950

Speaker Request Form (Chris Harris Test Page)

Speaker Request (Copy for Chris Harris Tinkering)

Contact Info

Name(Required)

Organization Info

Address(Required)

Event Details

MM slash DD slash YYYY
Address(Required)
MM slash DD slash YYYY
Speaker Start Time(Required)
:
Speaker End Time(Required)
:
Will the speaker have the ability to display slides?(Required)

Room Setup & Technology

What technology options are available to the speaker?(Required)
Will there be an opportunity for the speaker to test their slide show and audio before speaking?(Required)
May we get a list of everyone in attendance for the speaking session?(Required)
Will the event be photographed, livestreamed, or recorded?(Required)
Please check all that apply.
Will there be social media promotion of the event?(Required)
Please check all that apply.
Will there be press at the event?(Required)

Honorarium

Honoraria from speaking events helps the Kansas Leadership Center engage more Kansans in our core programs and compensate KLC for travel/material coasts associated with your event.
What level of honorarium are you able to offer KLC for providing a speaker at your event?(Required)

Travel

Would you be willing to cover travel expenses for a KLC speaker? We charge the IRS standard mileage rate of 57.5 cents per mile. We will calculate and invoice for the mileage after making the trip.(Required)

Books

KLC's book, Your Leadership Edge is a hit with audiences. Providing the book to your participants will help the ideas explored in our presentation stick. These books are priced at $19.95 each.
How many books are you interested in purchasing for your event?(Required)
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