Terry Watson - International Speaker

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Please fill out the short form below, then make your payment online. Thank you

Contact Information:

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Office Phone:

Cell Phone:

Organization Information:

Sponsor/Company:

Address:
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Office Phone:

Fax:

Event Details

A. What Topic would you want Terry to speak on? (Keynote/Course/Seminar Name):

    B. What Date would you like Terry to speak?

       1st Choice: 2nd Choice:

    C. Event Name and Group being Addressed:

        Event Name:

     D. Group being addressed and approximate group size:

        Group Name:    Group Size:

    E. Event Location/Venue:

Name:
Address:
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F. Please state any questions that you would like answered when we contact you:

Travel Details

A. What is the nearest major airport to the meeting site?

   B. Please Confirm...

      Sponsor will pick speaker up from airport: YES NO

      Sponsor will book and master-bill hotel: YES NO

   C. Nearest full service hotel where speaker should stay?

Hotel:
Address:
City:	State: Zip:
Phone #:

THANK YOU FOR BOOKING TERRY WATSON Once you submit the form, please make your online deposit.

Phone and Fax: (773) 404-7721, Toll Free: (888) 430-7650 Email: info@TerryWatson.com