Speaker Request Form

Thank you for requesting Jade Bryan for a speaking engagement. Your form will be evaluated and taken into consideration. If the engagement is in line with Jade Films’ mission, available resources, and schedule availability, the request will be considered.  

Depending on your request, please note that Jade travels with a personal assistant to all speaking engagements. Please allocate your budget to pay for two people when booking Jade for a speaking engagement. This includes Jade's personal interpreter.

For your request to be considered, please complete and submit this form electronically so that your form may be processed for consideration.

Submitting request forms as far as possible in advance is strongly recommended.

PLEASE NOTE: A podium, American Sign Language interpreter(s), microphone, LCD projector will be required for all presentations. All technical requirements must be confirmed prior to the event.

Please complete the Speaking Engagement Request Form below. 

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Email *
Name *
Address  *
City, State & Zip code *
Home phone # (Phone/Text/Videophone/Other) *
Name of Event *
Date of event *
Time of event (Start/End) *
Location of event *
Audience Size *
Audience profile *
Event focus *
Speaking Topic *
Required

Will your organization pay for the following expenses incurred by the speaker?

 *
Required

Honorarium / Speaking Fee Amount

 *

Will the speaker's bio and photo be required for advance PR?

 *

Will your organization be notifying the local media regarding this speaking engagement?


 *

Who is the contact person at your organization for media inquiries?


 *
AV Equipment Available
Check all that apply
 *
Required

Is there further information Jade needs to know regarding this speaking engagement?

Please feel fee to email us at JadeFilms@Gmail.com if you have any questions or concerns. Thank you for filling out the form!

 *
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A copy of your responses will be emailed to the address you provided.
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