Authors & Speakers

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to request a form that you can

complete by computer and email back to us.

Requesting Speaker(s):   Jim Conway      Jan Conway      Jim & Jan Conway

 

Event / Contact Information

 

Event Name:         

 

Event Location:         

 

Sponsoring Group:         

 

Event Coordinator:         

Coordinator’s Office Phone:         

Coordinator’s Cell Phone:         

Coordinator’s Email:         

 

Mailing Address:         

City, State, Zip:           

The following can be printed by clicking on the printer icon above (top left corner)

 

Jim and Jan Conway

Founders of LateLife Hope

LateLifeHope.com

P.O. Box 505, Conway, MI 49722

909-374-3569 – Lisa Kahan, Office Manager

 

 

 How to set up an event with speakers:  Jim and/or Jan Conway
 

1.    Email or call our office to see if your projected dates are open.

·        Email: This email address is being protected from spambots. You need JavaScript enabled to view it.

·        Phone: 909-374-3569

 

2.    Please be prepared to discuss marked items, such as:

 ·        Location of event.

 ·        Number of speaking times/sessions during the Seminar/Conference.

 ·        Expected audience number and age range of the group.

 ·        Honorarium, and travel expenses.

 

3.    After talking with us about event dates, those dates will be held for 2-3 weeks awaiting the arrival of this "Speaker Information Form"

·        by email to This email address is being protected from spambots. You need JavaScript enabled to view it.   OR

·        A complete copy of the form to each address by mail:

       1-  LateLife Hope, P.O. Box 505, Conway MI 49722

       2-  LLH, Attn: Lisa Kahan, 2583 Steeplechase Way, Norco, CA 92860

 

4.   You will receive a confirmation letter after your date is approved / reserved.

 

5.   We would be happy to assist with, and suggest; a final seminar timeline, promotion ideas, brochures / fliers, mailings, and other details.

 

After this form is returned to our office and you receive a confirmation letter, a cancellation fee of 25% of the honorarium will be assessed on the party who cancels the engagement. The canceling party will also be responsible for any non-refundable airfare costs.

 


 

Speaker Information Form

 

Requesting Speaker(s):

 

___ Jim Conway    ___ Jan Conway   ___ Jim & Jan Conway

 

Event / Contact Information

 

Event Name:

 

Event Location:

 

Sponsoring Group:

 

Event Coordinator:

 

Coordinator’s Office Phone:

 

Coordinator’s Cell Phone:

 

Coordinator’s Email:

 

Mailing Address:

 

City, State, Zip:

 

Number of people expected to attend:                             Age range:

 

Typical attendee’s background:

 

Would you like a mailing list of our friends / followers in your area, to send event invitations to?                   If yes, emails, addresses, or both?

 

Do you need publicity photos, speaker bios, or both?

 

Will there be other speakers at the event? If yes, who?

 

Will a bookstore, or organization, be selling books? If yes, what is the name of the organization?

 

Check all that you can supply:  

___ P.A. System

___ Lapel Microphones

___ Video Projector (or large screen TV)

 

 

  Event Details

Please call our office within the next two weeks to discuss the items on this page before returning this form. It’s ok if you don’t have all of the specifics yet.

 

Event Dates:                                                          Fixed___      OR Tentative___

 

Specific content to be covered:

 

Event session(s) schedule:

 

Specific speaking schedule during each session:

 

  Honorarium

Honorarium (Please write a specific U.S. dollar amount)     $______________________

*Honorarium check is made payable to LateLife Hope.

Will the honorarium be given:   in advance____    OR  last day of event____

 

  Overnight Accommodations

Please choose a hotel with room service.

 

Hotel Name:

 

Location:

 

Phone #:

 

  Air Travel Details

Air travel arrangements will be made by the LateLife Hope office.

*The travel expense check is made payable to LateLife Hope.

 

Will air travel expenses be covered in advance?______________

Recommended airport for arrival:

 

Will you have someone drive the speaker(s) to / from airport?

If yes, please list contact’s name?

 

Contact’s cell phone:

 

Contact’s home phone:

 

 Car Travel Details / If speaker(s) drive to the event.

*The travel expense check is made payable to LateLife Hope.

 

Will gas/mileage expenses be covered at $.60 per mile in advance?

 

Prayer Requests (Please list anything regarding the event that you would like us to join you in praying about)

 

© Copyright 2013 LateLife Hope. All rights reserved.

Speaker Information Form

Note: Fields expand to accept your entries. Tab key will take you to the next field.

 

Requesting Speaker(s):   Jim Conway      Jan Conway      Jim & Jan Conway

 

Event / Contact Information

 

Event Name:         

 

Event Location:         

 

Sponsoring Group:         

 

Event Coordinator:         

Coordinator’s Office Phone:         

Coordinator’s Cell Phone:         

Coordinator’s Email:         

 

Mailing Address:         

City, State, Zip: