Potential Speaker Interest Form
Thanks for your interest in speaking at Ellevate Foundations' 2027 Women's Leadership Summit (WLS), an event curated specifically by and for female leaders in the insurance and benefits industry. Please complete the info below and we'll be in touch with you soon if we have a potential spot for you to consider.
Speaker Name
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First Name
Last Name
Speaker's Organization
Speaker's Email
*
example@example.com
Speaker's Phone Number
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Please enter a valid phone number.
Format: (000) 000-0000.
Speaker's URL
Speaker's LinkedIn Profile
Speaker's Instagram Profile
Booking Representative (if applicable)
First Name
Last Name
Booking Representative's Email (if applicable)
example@example.com
Booking Representative's Phone Number (if applicable)
Please enter a valid phone number.
Format: (000) 000-0000.
Which of the following focal points resonate most with your passions? (check all that apply)
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Leadership
Empowerment
Wellbeing
Which of the following format(s) do you have prior experience with? (check all that apply)
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Keynote
Workshop
Moderator
Panelist
TED-Style (brief + impactful)
Please share your 3 most impactful qualities as a speaker.
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Please briefly describe the key messaging, themes and/or takeaways in your portfolio of content.
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If you have a formal Speaker Bio, please share it here.
Do you typically charge a fee for your speaking engagements?
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Yes, and this is non-negotiable
Yes, but willing to waive for this non-profit engagement
No fee for this engagement
Anything else you'd like to share with us for consideration?
Who can we thank for introducing you to Ellevate?
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Submit
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