1. SPEAKER BIO AND INFORMATION FORM-Long Form
Contact Information:
Name: __________________________________________________________
Address: ____________________________City: ________ State: ____ Zip Code: ______
Email Address: ________________________ Cell Phone#: _________________________
Biographical Information:
Short Bio: __________________________________________________________________
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Complete Bio:__________________________________________________________________
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Flight Information: Please make flight arrangements for me.
Legal Name: _______________________________
DOB: ______________________ Departure Airport: __________________
Preferred Airline: __________________ Frequent Flyer # ________________________
(If Applicable) Passport Number: ________________Passport Expiration Date: ____________
Hotel Information: Please make hotel reservations for me
Name as it appears on my ID: _______________________________
Preferred Hotel Chain: __________________ Frequent Traveler # ___________________

2. SPEAKER BIO AND INFORMATION FORM-Long Form
Car Rental Information: Please make car rental reservations for me
Name as it appears on my ID: _______________________________
DOB: ______________________ Driver’s License #: __________________ State: _______
Preferred Car Rental Company: __________________ Membership # _________________
AV Needs:
Projector: Laptop: Microphone: (Type: _____________)
Remote: ______________________ Other: ____________________________
I use: PC MAC Presentation Format: Keynote Powerpoint
Handouts/Resources:
Handouts: I will bring my own copies/handouts Please make copies for me
Resources: Title: ______________________ Cost: _____________
Title: ______________________ Cost: _____________
Title: ______________________ Cost: _____________
Resource Set Up Needs: _______________________________________________________
Special Requests: (Dietary needs, allergies, or other special requests below)
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