Booking Aly Pain To Speak

Please complete the following form with as much information as currently available.

You will be contacted by Aly Pain or her assistant to review details and clarify your specific needs (event and keynote topics aligned, book orders, follow up Executive and Team Coaching support, etc.).

We will create a written summary of expectations and logistics from our conversation(s), and request a 50% deposit to confirm your event in our calendar. The remaining 50% is due on the day of the event.

Books will be shipped in advance for sale at the event, or for advance distribution as per the request of the event sponsor. All travel and shipping expenses are the responsibility of the event sponsor.

 

Aly's executive and team coaching services are available to her clients at a discounted rate for 12 months after the keynote event.

• Name*
• Organization
• Email*
• Phone*
• Mobile

• Event Date (YYYY-MM-DD)*
• Event Topic
• Location
• Estimated Audience
• Audience Demographic
• Lenght of Time Alloted
• Budget
• Are there any responsibilities outside of speaking?
  Yes
  No
• Will there be audio / visual available?
  Yes
  No
• Space available for book display?
  Yes
  No
• Would you like books for your audience? If so, how many?

• Additional Information