CO+HOOTS In-Person Speaker Application

Full Name:* This field is required.

Title:* This field is required.

Organization:* This field is required.

Email:* This field is required.

Your Address:* This field is required.

LinkedIn:* This field is required.(Ex. https://linkedin.com/in/jennypoon)

Twitter:Include whichever account(s) you want us to tag you in. (Ex. @cohootsphx or @poondingo)

Facebook:Include whichever account(s) you want us to tag you in.

What gender do you identify as?* This field is required.

Female

Male

Non-binary/third gender

Prefer not to say

How do you describe your ethnicity?* This field is required.

Hispanic, Latino or Spanish origin

Native American or Alaska Native

Asian

Black or African American

Native Hawaiian or other Pacific Islander

White

Don't wish to answer

Do you speak any of the following languages:* This field is required.

Chinese (Mandarin)

Chinese (Cantonese)

Vietnamese

Spanish

Korean

None

Other

Phone Number:* This field is required.

Area Code

Phone Number

Bio:* This field is required.2-3 Sentences or Short Paragraph about your experience & expertise.

Upload your headshot:Or link to your headshot in the next step.

Drag and drop files here

Select files to upload

Max. file size: 1.0MB

Link to your headshot:* This field is required.

Choose your area of expertise:* This field is required.

Business Strategy

Finance

Legal

Marketing & Sales

Operations

Product & Service Development

Web & Tech

Years of experience with this area of expertise:

Under a year

1-2 years

3-5 years

6-10 years

10-19 years

20+

How much would you normally charge for your services per hour?

$25-$49

$50-$99

$100-$149

$150-$199

$200-$499

$500+

Which CO+HOOTS location would you like to speak at?

Phoenix

Mesa

Title for your speaking session:* This field is required.Try to be witty, clever titles do the best! Ex. 5 steps to grow your business, Sales tips from pros, How to operationalize your life, How to Destroy Your To Do List)

Abstract:* This field is required.Give us two to three paragraphs max about what an attendee will learn. Make it as specific as possible.

What are three key things the audience will be able to do after attending your session? * This field is required.Example: "Each attendee will be able to leave with a business plan" or "Everyone will be setup with task management processes and tools to onboard team members"

Would you like to sponsor lunch for this event?Typical budget is $75-$100. As you may know, a Free Lunch earns more RSVPs. But this is OPTIONAL. If yes, our Community Coordinators and Managers can work with you on lunch catering options.

YESNO

Past Speaking Experience:(link to online videos or summaries/reviews of previous speaking engagements a major plus)

I agree that I may be taped, live streamed and my presentation may be disseminated. I also agree to wear a clip-on mic provided by CO+HOOTS for the stream and to record a 1-2 minute intro and outro for the recorded version. (Intro/outro recordings will be done half-hour before speaker series event starts.) * This field is required.

I agree that you can use this presentation and the information therein for future purposes.* This field is required.

I agree to share my speaking session with my social network once it is confirmed to help build access to my great presentation.* This field is required.