YP Speaker Information

Thank you for agreeing to be a part of a Young Professionals Speaking Opportunity.

To ensure the best outcome and to share a little bit about you with our guests, please fill out the information below. We will not share your personal information with our guests.

Thank you!

Formal Name*

First NameLast Name

Preferred Name for Nametag*

Professional Title*

Current Employer*

Preferred Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Preferred Phone Number for Day of Event*

Please enter a valid phone number.Format: (000) 000-0000.

Preferred Email*

example@example.com

Please provide a short bio that will be used for marketing purposes.*

Please provide a brief description of your presentation/program that will be used for marketing purposes.*

Please provide a headshot that will go with your bio. (Formats: PNG, JPG)*

Please provide your company logo if speaking in your capacity and/or on behalf of your company. (Formats: PNG, JPG)

Will you have a PowerPoint/video presentation?*

YesNo

Will you need a laptop or be bringing your own? (An LCD projector and clicker will be provided)*

Yes, I will need a laptopYes, I will be bringing my own laptopNo

If bringing your own, what type of computer will you bring?*

Dell/PCApple

Will you have any handouts to share?*

YesNo

Will you have any digital files to share?*

YesNo

Any dietary restrictions?*

YesNo

If yes, please include them below.

Any special accommodations needed?*

YesNo

If yes, please include them below.

Please send your PowerPoint/handouts to info@westfieldchamberindy.com by noon the day prior to your presentation.

If you have any questions about your speaking engagement, please contact info@westfieldchamberindy.com. Confirmation about location and time will be sent 48 hours in advance.