Event and Appearance Requests





Event Details

Name of Event*

Host Organization*

Nonprofit

Event Date (YYYY-MM-DD)*

Speaker's Arrival Time*

Speaker's Departure Time

Dress Code

Estimated Attendance

Event Location*

Event Address*

Parking Instructions

Booking Details

Booking Contact Name*

Email*

Phone*

Cell Phone

Speaker Request

Name of Talent Requested*

Duty*
 MC Auctioneer Speaker Interviewer Moderator Judge Other

Will a Meal Be Provided?

Is the Speaker Allowed to Bring Guests?

If So, How Many?

What Do You Need from Houston Public Media?*
 Bio Headshot Other

If Other:

The Event Will Be...*

If Scripted, Organization Will Email Script By This Date (YYYY-MM-DD)

Confirmation Deadline (YYYY-MM-DD)*

Event Privacy

Is This Event*

Is There a Facebook Invite?*

May We Link to the Facebook Invite?

Event Website

Info & Reservation Number

Additional Details

Include Any Additional Notes Here

* = required field