Your Information

 Name:
 Job Title:
 Work Email:   Work Phone:   Work Fax:

Institution Information

 Department:
 Institution:
 Address:
 City:   State:   Post Code:
 Country:

Event Needs

What Type of Event: (e.g. Asian American Heritage Month, etc.)
Event Date: (mm/dd/yyyy)    Event Time:
Arriving: (mm/dd/yyyy)    Departing: (mm/dd/yyyy)
How much time for presentation?
Purpose of Event: (e.g. to inform audience of the importance of ethnic studies, etc.)
Theme of Event:
Audience: (number and students? faculty? etc.)
What should presenter accomplish?
How many other presenters? Who are they?

Speaker Accommodations


Check should be presented to speaker on the day of speaking engagement. If you wish to make other arrangements, please speak with agent. Client is responsible for flight reimbursements even if the engagement is cancelled.

TRAVEL
Choose from the following:
Air (American Airlines) Train Business Coach First-Class None

Travel Company

HOTEL (non-smoking)

Name of Hotel:
Address of Hotel:
Phone of Hotel:

CAR (Pick-up to & from event)
Choose from the following:
Limousine Town car Personal pick-up Rental No Car Provided

Company name or personal contact name:
Phone of company or personal contact:

MEALS
Choose from the following:
Breakfast Lunch Dinner No Food Provided


HONORARIUM FEES*

Choose from the following:
Workshop Keynote Other: (Please Specify)
* Fees Negotiable

Copyright, License, and Intellectual Property

The entire contents of Gary Okihiro’s public speeches and workshops are protected by international copyright laws. The owner of the copyrights is Gary Okihiro. YOU MAY NOT MODIFY, COPY, REPRODUCE, REPUBLISH, UPLOAD, POST, TRANSMIT, OR DISTRIBUTE, IN ANY MANNER, THE MATERIAL ON THE SITE OR THE CONTENT OF GARY OKIHIRO’S SPEECHES AND PUBLIC APPEARANCES, INCLUDING BUT NOT LIMITED TO QUOTATIONS, TEXT, GRAPHICS, CODE AND/OR SOFTWARE. You may print and download portions of materials from the different areas of the Website solely for your own non-commercial use provided that you agree not to change or delete any copyright or proprietary notices from the materials. You agree that Gary Okihiro alone has a worldwide, perpetual license to the ideas contained wthin this Website and in his public speaking engagements.

You agree that all materials and information from any public appearances by Gary Okihiro are protected by copyright laws, and may not be reproduced, republished, distributed, transmitted, displayed, broadcast or otherwise exploited in any manner without the express written permission of Gary Okihiro.

Customer Signature: (electronic)    Date: (mm/dd/yyyy)