Speaker Request Form

Our deep bench of energizing facilitators, teachers, and coaches is ready and excited to deliver a KEYNOTE, a TEACHING SESSION, or a FACILITATION SESSION for your event.

Please complete the form below and a member of our staff will contact you to discuss the details of your engagement.

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Organization Info

Host Organization(Required)

Organization Address (for invoicing purposes)(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Is your organization a KLC Leadership Transformation Grant (LTG) Partner?(Required)

Yes

Is your organization a KLC Community Leadership Program (CLP) Partner?(Required)

Yes

Primary Contact Info

Name(Required)

Prefix First Last

Email(Required)

Phone(Required)

Job Title

Request Info

The Kansas Leadership Center’s Speakers Bureau provides thought-provoking and practical presentations that help individuals and organizations address leadership challenges. Designed to inspire and engage, our sessions focus on the core principles of leadership as practiced and taught by KLC.

Please select the option that BEST aligns with your event needs:(Required)

Keynote Presentation: A 1-hour or shorter engaging, high-energy introduction to KLC’s core leadership principles, designed to inspire and challenge audiences to see leadership as an activity, not a position. Tailored for groups or conferences, it blends storytelling, key insights, and practical takeaways to spark curiosity and motivate action.

Interactive Teaching Session: A 2-3 hour session introducing the KLC Leadership Framework. This option is suited for groups interested in a more interactive experience where participants can begin applying KLC principles in real time.

Facilitated Discussion: A facilitated session lasting 2-3 hours, tailored to a specific challenge or organizational need. These sessions are a collaborative process where the facilitator guides discussion, encourages reflection, and draws out insights from participants rather than delivering content.

Any other engagement over 3 hours

Please describe your goals and objectives for this engagement (list any topics or themes you'd like to be included):(Required)

Are you requesting a specific KLC speaker? If so, who?

Have you already connected with a KLC staff member about this event? If so, who?

How did you hear about KLC's Speaker's Bureau?(Required)

KLC Sessions often expand on ideas from our books; "When Everyone Leads" and "Your Leadership Edge". Would you be interested in purchasing books to supplement this engagement?(Required)

We offer discounted bulk rates for Speaker Bureau requests. (20 copies or more)

YES - When Everyone Leads

YES - Your Leadership Edge

NO we are not able to purchase books at this time

Engagement Info

Describe the Event (conference, training, workshop, retreat, panel discussion etc.)(Required)

If this event is multiple days OR this session will be part of a larger event, please let us know.

DATE Requesting Speaker(Required)

Speaker START time(Required)

Speaker END time(Required)

If you're requesting multiple days/multiple sessions OR that the speaker be present outside of the start and end time indicated above (i.e. Q&A, lunch, mic check, etc.), please explain:

Name of Engagement Location

Address of Engagement(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Estimated number of attendees:(Required)

Please share any information you have about the demographics of the expected audience that might help us match you with the best speaker. (age, race, gender, positions, locations)

Will there be any live streaming, virtual attendees, or press present? Please explain.

Is there anything else that would be helpful for KLC to know as we consider the request?

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Speaker Request Form

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