Speaker Data Sheet and Membership Application

 1. WRITE YOUR OWN PROFILE. PREFERRED FORMAT: FOLLOW THE FORMAT USED IN THIS EXAMPLE (www.commissionfreespeakers.com/template.html)

2. ALTERNATIVELY, USE THE FORM BELOW TO GIVE THE BASIC INFO (which won't be as extensive).

Copyright Andrea Reynolds 1991-2009

Please insert the text into an email (not an attachment) to Andrea Reynolds: adviceempire@gmail.com

Incomplete forms will not be processed; this info will be used for your online speaker profile in you don't write your own.

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EXPERTISE

Your specialized expertise is:



CONTACT DATA

Speaker Name:

Today's Date:

Company name:

Phone:

Cell phone:

Fax:

Web site:

Email:

Address:

City:

State/Prov:

Postal Code:

How did you hear about Commission-Free Speakers?


SPEAKING EXPERIENCE

I have been speaking since (year):

I have been receiving payment as an independent professional speaker since (year):

The largest fee I have received for a keynote presentation: $________ (not to be published).

(Your fee info will remain private. This info will help us determine which fee categories you can be listed in - if we decide to post fee levels - and also to help you later with fee negotiations.)


PAST AUDIENCES List your experience as a paid/ unpaid speaker:

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AWARDS List any awards received:

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PASSION Insert paragraph: Tell why this is your passion or why you became an expert in this niche. This paragraph will be used on your full page web page as an introduction next to your photo.


BIO Insert your introductory bio. This will appear on your speaker profile.



TITLES
List your own, original "information products" to which you own the rights which may be figured into negotiations. (Books, booklets, special reports, magazines, video tapes, newsletter, audio tape, other.)

Give TITLES AND PRICES.

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Your top LECTURE TITLES are:

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Your SEMINAR/WORKSHOP TITLES are:

Please provide 1-2 sentence descriptions and indicate ideal audience.

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DESIRED AUDIENCES
Specific organizations I would like to address (types and/or specific names): Name the desired organization.

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PAST AUDIENCE TESTIMONIALS

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SPEAKING FEES (not for publication)

Your FEE information is held in STRICT CONFIDENCE and will not be published. We will use this info to assist you with private advice and contract negotiaton. If you want some help with fee-setting and quoting in the future please order this comprehensive e-Report, Secrets for Setting and Quoting Your Speaking Fees.

Assume these would be for presentations given some distance from your geographic location.
The FEES You CURRENTLY RECEIVE for lectures and seminars are (give high and low for each):

Presentation Length 1.BEST fee received 2. Lowest acceptable fee

Keynote Address (20-30 min.)

Panel Discussion participation

Lectures ...............

20-30 minutes

30-45 minutes

60-75 minutes

90 minutes

120 minutes

Workshops and seminars.......

Half day (3-4 hrs)

Full day (6-8 hrs)

Two days (12-16 hrs)

Three days (18-24 hrs)



Indicate how you wish to be paid: [ ] US funds [ ] Canadian funds [ ] other ____________


POLICY / CONTRACT TERMS

SPECIAL contract terms, over and above basic terms, I MUST have: (Don't skip. These are important negotiation points and we can cover these in a private consult or contract critique.) See article for some ideas.

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Not sure what contract terms to list above? Order my e-report: 33 Amenities That Speakers Deserve (negotiable contract terms)


Please send the following materials ELECTRONICALLY which will be used to assess your experience as a professional speaker. (Send by email or email attachment, or give us permission to "lift" these from your web site. Please provide page URL.)

[_ ] PHOTO .jpg (head shot and/or action photo: black & white or color)

[ _] Speaker's narrative BIO (not a resume or fact sheet) - 1/2 page maximum

[ _] Description of each LECTURE listed (1-2 sentences, indicating ideal audience)

[_ ] Description of each SEMINAR/WORKSHOP listed (1-2 sentences, indicating ideal audience)

[ _] List of PAST AUDIENCES (no more than 12, preferably in last 12 months)

[ _] Audience evaluations, unsolicited testimonials from letters of recommendation, etc. (3-4)

[ _] 3 speaking contracts from the past 12 months which show fees you have received, even if no fees were received.


If you don't use written contracts, please consider one of the services we offer for developing a good contract to protect your interests.


Insert the text into an email (not an attachment) to Andrea Reynolds: adviceempire@gmail.com


Also, send by mail:

[ ] Audio or video tape of a recent, actual presentation (not an infomercial or contrived demo). Without this we cannot vouch for you as a speaker or ascertain your level of professionalism.


Ask for a mailing address.

Remit US $99.00 membership payment for one year: PayPal (scroll down page for button), debit/credit card, check or money order.


Phone orders: (412) 440-3704