Booked Speaker Contract Name* First Last Email* Phone*Date Agreed Upon To Speak* MM slash DD slash YYYY Time Agreed Upon To Speak* : Hours Minutes AM PM AM/PM (Speakers should be available 1 hour prior to start time of event.)Please share with us the topic on which you will be speaking, and include a summary of your presentation (please include a list of your main talking points).*Please be as descriptive as possibleHow long do your presentations typically run?1 Hour1 1/2 Hours2 HoursOtherWhat do you need for your presentation?ProjectorScreenSpeakers/MicLaptop ConnectionsTableMusic from presentation(Use Shift/Cmd or Ctrl to select more than one)I acknowledge that recording devices will be used at this presentation* I understand the lecture will be videotaped and recorded for the purpose of being used and distributed in various formats by PAC for educational purposes, within the confines of the PAC members-only access areas including, but not limited to the PAC classroom, the Internet, and any other communications medium currently existing or later created. I authorize PAC, to videotape, audiotape, photograph, record, edit or otherwise reproduce my presentation, and likeness to use them in the formats and for the purposes stated above. Marketing of Lecture* I agree to send out two social media messages to my following about this event I am available to do a short (10 min) interview online one month prior to my lecture Will you be selling a product or service?*YesNoI will not flood the presentation with affiliate links, or products I am promoting*I agreeI disagreePresentations should be about the topic and not about specific brands, please keep it relevant, Thank you.Please share your bio with us so we know how to introduce you*Be as descriptive as possiblePlease upload a headshot and 2 other images for marketing use* Drop files here or Select files Accepted file types: jpg, jpeg, Max. file size: 10 MB, Max. files: 3. I agree to indemnify and hold harmless the PAC, their volunteers, employees and representatives against any and all claims arising out of my presentation, including, but not limited to, claims of copyright infringement, defamation, and misrepresentation. I declare I have read the above, fully understand its meaning and effect, and agree to be bound by it.* I agree Please digitally sign below to indicate your commitment to speak on the specified date & time for a PAC event.*I am sponsored by: (if applicable)