BOSS LADIES SIGN UP SPEAKER FORM

Thank you for expressing interest in becoming a speaker.

Please fill out the Speaker Application form below. Once we receive your completed application, it will be review by our team. We will reach out to discuss the next steps.

Boss Ladies Business Mixer provides a time slot of 15 minutes for each speaker presentation. Please note, subcontracting any portion of your allotted time to other presenters or sessions is not permitted.

SPEAKER OPPORTUNITY DATE (Select One)*

October 14, 2025November 11, 2025December 9, 2025

How did you hear about this event?*

Other

Contact Name*

First NameLast Name

Company Name*

Company Logo

E-mail*

Telephone*

Speaker Name(s) & Title(s)*

Please provide the names and titles of the speaker

Headshot(s) Format

• Shoulders and up are the best format, no full-body shots

• File Format: .JPG and .PNG files

• Please label all images with the name of the speaker i.e.: speakernamehere.jpg

• Must be at least 1080x1080px

No busy backgrounds - solid light color backgrounds. Please include a headshot with a white background if you would like to be included in our advertising materials.

Speaker Head Shot*

Presentation Title*

What are your current challenges in your business?*

What resources are you in need of?*

Gender*

MALEFEMALEOther

Age Range*

18-2930-4950-7475 +

You will receive a formal update regarding the status of your submission within three to four business days. We appreciate your patience during this process.