The New Blueprint Conference Official Speaker Application
“When preparation meets purpose, the blueprint becomes impact."
Before You Begin:
Please review all sections of the form before submitting. Applications are reviewed on a rolling basis early submissions receive priority. You may complete this form in one sitting or save and continue later using JotForm’s save feature. Prepare the following items before starting: A professional headshot (JPEG or PNG)A short bio (100–200 words)An optional video clip (60–90 seconds) showcasing your speaking style
“Write down the vision; clearly inscribe it on tablets so one may easily read it.” — Habakkuk 2:2 (CSB)
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Applicant Information
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Organization (If applicable)
Website (If applicable)
Instagram Handle
Facebook Page
LinkedIn
Please Upload a Professional Headshot
*
Browse Files
Drag and drop files here
Choose a file
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of
Professional Bio (100-300 words)
*
A public video sample link (ie. reel or post)
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Speaker Category: Please select all that apply
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Keynote Speaker
Breakout Session Speaker
Workshop Facilitator
Panel Speaker/ Guest Panelist
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Keynote- Submission Details
Complete if you selected Keynote
Proposed Keynote Title
Keynote Description (150-300 words): What transformation should the audience expect?
Briefly list 2–3 past keynote events (with links, if available)
Compensation Request (e.g., $500–$750) or Hotel Night
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Breakout- Submission Details
Complete if you selected Breakout
Session Title
Session Description (100–250 words)
Three Learning Outcomes (bulleted)
Engagement Strategy (Q&A, activities, etc.)
Compensation Request (if any) or Hotel Night
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Workshop- Submission Details
Complete if you selected Workshop
Workshop Title
Workshop Description (100-250 words)
Hands-on Component (Describe activity)
Materials Needed (if any)
Max Participants (recommended)
Compensation Request (if any) or Hotel Night
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Panel- Submission Details
(Complete if you selected Panel)
Area of Expertise
Suggested Panel Theme(s)
Preferred Co-Panelists or Moderators (optional)
Brief Bio Relevant to Panel Topic (100-200 words)
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Faith & Values Alignment
In 2–5 sentences, share how your values align with the mission of The New Blueprint Conference:
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Marketing & Promotion
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Instagram Live (Pre-conference)
Short promo video (30-60 sec)
Podcast or interview feature
Share conference posts to your audience
Provide headshot + bio by March 28, 2026
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AV/ Tech Needs
Microphone Preference (handheld, lavalier, headset):
Stage / Room Setup Needs (screen, clicker, table, etc.):
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Referral & Awareness
How did you hear about us?
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Instagram Story
Instagram Post
TikTok
Facebook
Email Newsletter
Speaker/ Influencer Referral (enter name below)
Conference Website
School Childcare Owner Referral (enter name below)
Other
Referral Name
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Acknowledgments & Submission
Please check all options acknowledging that you understand the guidelines listed.
*
I affirm that the information provided is accurate and complete.
I understand applications are reviewed on a rolling basis.
I agree to provide headshot, bio, and materials by deadlines if selected.
I understand that an NDA will be required if I advance to interview.
I agree to uphold professionalism and the mission of The New Blueprint Conference.
Please print your full name here.
Signature
Date
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Month
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Day
Year
Date
“Write down the vision; clearly inscribe it on tablets so one may easily read it.” — Habakkuk 2:2 (CSB)
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