Book Tony Williams — The Olandus Foundation

SECTION 1 — YOUR CONTACT INFORMATION

*First Name

*Last Name

*Title / Role

*Organization or Company

*Email Address

*Phone Number

Organization Website

*Organization Type

SECTION 2 — EVENT DETAILS

*Event Name

*Event Type

*Preferred Event Date

Alternate Date (if any)

*Event Start Time

*Tony's Session Start Time

*Session Length

*Session Format

SECTION 3 — VENUE & LOCATION

*Event Delivery

In-Person Virtual Hybrid

Venue Name

Leave blank if virtual.

Venue Address

City

State

If Virtual or Hybrid, Platform Used

SECTION 4 — AUDIENCE INFORMATION

*Expected Attendance

*Primary Audience Type

Audience Age Range

Underrepresented Communities Present?

Yes No Not Sure

*Describe your audience's primary needs, challenges, or goals

SECTION 5 — SPEAKING TOPIC & GOALS

*Preferred Speaking Topic

Healing Forward Purpose After Pain Building Health Equity in Underserved Communities The Power of Us in Healthcare & Trials Cancer Education & Early Detection Clinical Trial Diversity & Representation Custom Topic (describe below)

*What do you want your audience to walk away knowing, feeling, or doing?

What is the theme or central message of your event?

SECTION 6 — BUDGET & LOGISTICS

*Honorarium Budget

Is budget flexible?

Yes No Negotiable

*Will you cover travel costs?

*Will you cover lodging?

AV / Tech requirements available?

Yes No Not Sure

Mic, screen, clicker, reliable internet.

Speaker ready area available?

Yes No Not Sure

SECTION 7 — ADDITIONAL INFORMATION

*How did you hear about Tony?

Is this a paid or free event?

Paid Free Fundraiser

Are other speakers confirmed?

Yes No

Additional notes or requests for Tony's team

SECTION 8 — ACKNOWLEDGMENT & SUBMISSION

Please read before submitting:
By submitting this form, you confirm that the information provided is accurate. Submitting this form does not guarantee a booking. Tony's team will contact you within 48 hours to discuss availability, terms, and next steps. A signed agreement and deposit are required to confirm the engagement.

*Your Full Name (confirms acknowledgment)

*Today's Date

I confirm all information is accurate and understand this is an inquiry, not a confirmed booking.

THE OLANDUS FOUNDATION