Business luncheon - keynote speaker request

Presentation Request

You are requesting to be the 20-minute keynote speaker/presentation at the Chamber's Weekly Business Luncheon. Your presentation should be no longer than 20 minutes. Based on the meeting's agenda for which you may be scheduled, you may also have an additional 5-minutes for a Q&A session. Completion of this form does not guarantee a scheduled presentation.
Who is the main point of contact?

Who should we contact with questions and day-of instructions?
Contact person name*
Contact person title*
Contact person phone number*
Contact person e-mail address*
Who is presenting?

Information submitted will be used on marketing materials.
Keynote speaker name*
Keynote speaker position within business/organization*
Business/organization*
When would you like to present?

We will follow up with the main point of contact to confirm the date of presentation. Weekly Business Presentations are held on Tuesdays.
Please rank preferred dates to present. If the presentation can only be done on one particular day, please select the same date for all three options.

MonthDayYear
MonthDayYear
MonthDayYear
Tell us about your presentation.

Information submitted will be used on marketing materials.
Title of the presentation (Have fun with it! The more exciting the title, the better the turnout. Please don't use the word 'update'. Get creative!)*
Please provide 3-5 sentences on what our members can expect to hear/learn about from the presentation, including how it relates to the GFCC membership & business community. This information will be used to help market the luncheon to our members & the general public.*
Please upload your logo.

Upload a File

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Please upload the keynote speaker's bio.*

Upload a File

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Please upload the keynote speaker's picture.*

Upload a File

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Please upload any pictures or other graphics you wish to share.

Upload a File

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Does your presentation require Audio/Visual Technology?*

YesNo
Does the Chamber have the permission to share your presentation / visual aids?*

YesNo
Is there someone you have in mind or is there someone you would like to request to introduce the keynote speaker?

YesNo
Name and title
Would you like to donate a prize for our 50/50 drawing?*

YesNo
Prizes may include your company's products or services, gift cards to your favorite Chamber members, logo items, or anything else you would like to use.
What would you like to donate?
Please bring the item(s) with you the day of the event.
Notes & Special Requests
Were you referred by a Chamber Committee, Board Member of Staff member?

YesNo
Please tell us who referred you.*
Should be Empty:

Presentation Request

Who is the main point of contact?

Who is presenting?

When would you like to present?

Tell us about your presentation.