Speaker Information Request
Holistic Leadership Council March 9th-12th
Name
*
First Name
Last Name
E-mail
*
example@example.com
Phone Number
*
-
Area Code
Phone Number
Please indicate any and all SESSION CATEGORIES you would like to lead
*
Rows
Yes
No
Experience- ie.; Guided Meditation, Breathwork, Yoga etc...
Networking Session
Team Building Activity
Ted-Style Presentation (30 mins)
Session Title #1
*
Session Category #1
*
Session Description #1
*
Will you need screen and projector for powerpoint?
*
Yes
No
Will you need music played?
*
Yes
No
Will you have videos that need to be played?
*
Yes
No
Additional Notes About Your Session we should know:
Session Title #2
Session Category #2
Session Description #2
Session #2 Time Length Preferred
Will you need screen and projector for powerpoint?
Yes
No
Will you need music played?
Yes
No
Will you have videos that need to be played?
Yes
No
Additional Notes About Your Session we should know:
Session Title #3
Session Category #3
Session Description #3
Session #3 Time Length Preferred
Will you need screen and projector for powerpoint?
Yes
No
Will you need music played?
Yes
No
Will you have videos that need to be played?
Yes
No
Additional Notes About Your Session we should know:
Thank you. We will be in touch if your session(s) is accepted. Please note not all sessions will be accepted. Also please note time lengths are based on availability in the schedule
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