Kordell Norton - Speaker
PROGRAM INFORMATION SHEET
To be completed by client
Address: ______________________________________________________________________________
Contact: ________________________________ Phone: ______________________________________
Program Date: ________________________ Attire: Black Tie _____, Business _____, Bus/Casual _____
Speaker Times: Start ________________________ End ____________________________
Event Address: _________________________________________________________________________
Phone #: ____________________________ Events/Dinners/Receptions: __________________________
Meeting Room Set Up: Classroom style_____ Auditorium _____ Other ___________________________
Speaker audio/visual requirements: Wireless lavaliere microphone: ______X______
Overhead projector: _____________ Table for materials in back of room: ______________
Flip chart: ________________ Full lighting: __________________
Hotel Accommodations: _________________________________________________________
King size bed/Non-smoking room/Conf # ______________________ Date: _________
Address: ______________________________________________________________________
Fax #: _______________________________ Phone #: ________________________________
How far from airport? ___________________________________________________________
Ground transportation-airport to hotel and return-will speaker be met or should they take a cab/rent a car?
______________________________________________________________________________
Emergency Contact & Phone #: Day: _________________ Person: _______________________
Evening: ________________________ Person: ________________________________
Any questions, please call: Kordell or Renee Norton, (877)660-4237 Toll Free or (330) 405-1950
Fax: (330) 405-9828
Please return form with confirmation to Kordell Norton Company.