Bold and Brave Speaker Application form

Bold and Brave Speaker Application form

Thank you for expressing an interest in speaking at our upcoming Bold and Brave Event! Kindly complete the information below, and a member of our team will be in-touch with you.If you have any questions, or need more information please contact us at: boldandbraveinfo@gmail.com
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Speaker's Name*

First NameLast Name
Speaker's Name as it should appear on Bold and Brave Materials*

First NameLast Name
Phone Number*
Format: (000) 000-0000.
E-mail*

Confirmation Emailexample@example.com
Address

Street Address

Street Address Line 2

CityState

Zip CodeCountry

Your online platforms*

Your Industry*
Company Name as Applicable.
Do you have a logo that you would like to share?

Cancelof
Your Professional Headshot (this will be used on our website and for promotional materials)

Cancelof
Your professional bio (written in third person). This will be shared on our webiste*
The title of your session is the first impression for Conference Attendees. Use a concise, but inclusive, title which clearly conveys what you will be presenting and draws attendees' attention to your topic.
Title of Your Session:*
Category *
Category Not Listed
Abstract: Your session abstract will tell Bold and Brave attendees why they should attend your session. To be effective and create interest, it should provide a brief, clear, and concise reflection of your presentation’s content. The abstract should only be one paragraph of between 150 to 250 words in length.*
Outline Your Key Elements. List 4 to 5 primary or key elements of your topic that you will be discussing.*
Target Audience
Have you given this presentation before and/or you do you intend to present it elsewhere in the near future?*
If YES, please list where and when - If NO place N/A in the box.*
I agree to submit my presentation prior to the Bold and Brave Event *
I understand that this is not a paid event*
Are you both an Exhibitor and a Speaker? In order to schedule your session properly, let us know.*
What would you like to sell?
Yes
Enter the message as it's shown*
Signature

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