Talk Boutique is proud to have you appear on our roster.
We’d like to get to know you just a little bit better, so we can provide you with the best possible service. Kindly complete this brief questionnaire.
Your Name (required)
Title (as you would like it to appear on our Roster):
Tagline Words (4-5 words ex “Author, Peacekeeper, and International Spy”):
What languages you present in?
Your Email (required)
Phone (required)
Billing Address
When is the best time to contact you?
MorningAfternoonEvening
Emergency contact (name, phone, email)
In which city do you currently live?
Date of Birth (Year/Month/Day) (required)
Talk Boutique would like to formally announce and welcome you to our roster via our social channels.
Do we have permission to welcome you to the Talk Boutique roster by:
Blog PostSocial Media PostEmail Newsletter
Are you exclusively represented by any of the bureaus that currently represent you? YesNo
If yes by whom?
If you have already provided these documents please skip to the next section. If these documents aren't available right now please send them to marylou@talkboutique.com when they are ready.
Please attach a high-res headshot (jpg, jpeg, png)
Please attach your biography (500 words maximum (doc, docx, pdf)
Please attach your keynote topic(s) and descriptions (doc, docx, pdf)
Video links that you would like to showcase on your roster page:
What is your website URL?
LinkedIn
Facebook Business Page
Twitter
Instagram
YouTube
Please confirm the following for transportation options
I have a valid Driver's licenseI have access to my own vehicleI prefer transit/taxi/Uber/car service
Full name as it appears on passport (required)
Preferred airport in home city
Preferred airline
Preferred airline seating
Aisle seatWindow Seat
If you have Nexus please provide details here
Frequent flyer program details (Name, number etc)
Hotel Loyalty program
Dietary requirements
Any accessibility considerations
Please provide some information / a few bullet points that we can use for your stage introduction:
Microphone preference
LavalierPodiumHandheld
How will you provide speaker support?
Own laptopMemory stickEmail
Are you providing a laptop from which to run your speaker support?
YesNo
What operating system do you have on your laptop
MacWindowsOther
What file format is your speaker support presentation in?
Power PointKeynoteOther
What version of the speaker support software are you using?
How will you advance your slides?
Laptop on stageWireless cue (Pickle)
Do you have a French version of your speaker support?
Do you have videos as part of your presentation?
Are videos embedded in speaker support file?
What file formats do you have the videos in?
Would you like us to request a chair/stool for your presentation?
Any AV requests/suggestions?
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