Submit A Speaker Request

Helping you find the perfect speaker for your seminar, conference or board retreat is a free service of CHG Group.

Please fill out the information below as completely as possible and someone from our team of experienced
educational program planners will contact you by phone with suggestions for speakers.

* REQUIRED FIELDS

*Name
Title
Organization
Address
City
State
Zip
*Phone
(No Hyphen or Parentheses)
Fax
*E-mail

Event Information

Type of event
Number of attendees
Date(s) of event

Are you able to change the date(s)?

Yes No

Time of day of speaking engagement
Location of travel (City, State)
Closest recommended commercial airport

We are looking for a...

Keynote presenter
Breakout presenter
Presentation moderator
Group facilitator

Please indicate the length (in hours)
of the presentation/facilitation:

hours

Are you looking for a speaker to present multiple presentations on different subjects?

Yes  No

Please indicate your budget
allocation for a single speaker:

$2,500 - $4,999
$5,000 - $7,499
$7,500 - $9,999
$10,000 and above

Comments and Topic Areas:
Please indicate the major focus of your event, and the topics/challenges that are of greatest interest
to your organization. Also include any comments and/or special requests.