Bookings

Part 1 : Event Organizer
Name of Organization Submitting Request :		Event Sponsor(s) :
Coordinator/Point of Contact Name :		Email :
Phone Number :

Part 2 : Event Details
Event Name/Title :		Event Location :
Event Date :		Event Time :
Event Type :		Other Event Commitments :

Part 3 : Presentation/Speech Details
Requested Topic :		Presentation Format :
Expected Time Duration :		Will There Be Audience Questions/Answers :

Part 4 : Audience Details
Audience Size :		Media Attendance :
Will Dr. Turner Lee's be Expected to Engage in Any Interviews? :

Part 5 : Additional Information
Will Dr. Turner Lee Be Required To Pay A Registration Fee?:		Is There Travel Assistance :
Is There An Honorarium and If So, How Much? :		Will Dr. Turner Lee Be Asked To Sign A Disclaimer or NDA as Part of Her Participation?