Speaker Request Form

Request a Kansas Leadership Center Speaker

Available for pre-order now.

Is your organization, business or community confronting a tough challenge or big opportunity, one that needs more leadership and engagement from stakeholders at all levels? We hold that progress on the most daunting challenges requires a culture where everyone leads. And we’re here to help with that!

Already the premier speaker bureau in the state, The Kansas Leadership Center is quickly establishing a national and even global presence as the center of excellence for leadership development and civic engagement.

If you want to hear about what is possible for your organization or community When Everyone Leads, we’re excited to incorporate our forthcoming book from Bard Press into your session.

Whatever the occasion, whatever the need — whether it’s strategic planning, a board or staff retreat, a symposium, conference, even a local Rotary Club meeting — KLC’s deep bench of energizing facilitators, teachers and coaches will design the right intervention to help you and your organization mobilize more people so you seize opportunities and make more progress on your toughest challenges.

Complete our form below and a member of our staff will respond right away.

Contact Info

Name(Required)

First Last

Email(Required)

Phone(Required)

Job Title

Organization Info

Organization(Required)

Address(Required)

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

Event Details

Date of Event(Required)

Are you requesting a KLC speaker for multiple dates / events?

If you are requesting a KLC speaker for multiple dates, please list the dates below.

Location of Event(Required)

Address(Required)

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

Is there a deadline for when you need to have a KLC speaker confirmed for planning purposes?

Event Start & End Time(Required)

Speaker Start Time(Required)

Speaker End Time(Required)

Choose the option from the menu that best describes your preferred speaking session:(Required)

If none of the sessions apply, please briefly describe the type of speaking session you are requesting:

Number of Attendees (Please be specific if possible. Estimates are acceptable.)(Required)

Have any attendees completed KLC programming in the past?(Required)

Could you tell us a little bit about this audience, such as demographics like age, race, & gender?(Required)

In your opinion, what would be the biggest leadership challenges this audience faces regularly?(Required)

Do you have any specific leadership topics or objectives you would like our speaker to address?(Required)

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

Describe the event – What are your goals for the event?(Required)

What expectations do you have of a KLC speaker?(Required)

Have you already talked with a KLC staff person about this event? If yes, please explain.(Required)

Will the speaker have the ability to display slides?(Required)

Yes

Do you need a copy of the speaker's bio and/or headshot? If yes, please specify your needs.(Required)

Room Setup & Technology

What is the room set up like for this event?(Required)

If other, please describe:

What technology options are available to the speaker?(Required)

If other, please describe:

Will there be an opportunity for the speaker to test their slide show and audio before speaking?(Required)

Yes

In all speaking events, KLC has a standard leave behind card which shares information on the leadership ideas and training opportunities. What would be the best option for making this available to participants:(Required)

If other, please describe:

May we get a list of everyone in attendance for the speaking session?(Required)

Yes

Will the event be photographed, livestreamed, or recorded?(Required)

Photography

Livestreamed

Video Recording

None

Please check all that apply.

Will there be social media promotion of the event?(Required)

Social media promotion prior to event.

Social media activity during the event.

No social media promotion.

Please check all that apply.

Will there be press at the event?(Required)

Yes

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)

Yes

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 $24.99 each.

How many books are you interested in purchasing for your event?(Required)

1 for each participant Fill in number below for key members of the group

We are not able to purchase books at this time

Number of Books

Any Comments?