L².I.F.T Speaker Pre-interest form
Thank you for your interest in being a speaker/panelist! We are excited about the opportunity to partner with you as we encourage, enlighten, empower, and enrich the lives of the women we serve. Please complete the application below. While we accept and review applications year round, Speaker Success Network membership opportunities only open up twice a year for select, limited periods of time. As team member will contact you to provide updates on available opportunities(as needed).
Name
*
First Name
Last Name
Email
*
example@example.com
City/Town
*
State/Province
*
Country
*
Phone Number
*
-
Area Code
Phone Number
Gender
*
Male
Female
N/A
Age
*
18 - 24
25 - 34
35 - 44
45 - 54
55 - 64
65 or older
What is your marital status?
*
Email
example@example.com
Which opportunities are you most interested in?
*
Workshop facilitation
Panelist
Main Stage
Other than financial compensation, what rewards or benefits do you value as a speaker(Please note: we do not currently pay speakers)
*
Selling from the stage
Letter of Recommendation/Referrals
Brand exposure(Ad, onsite, social media marketing)
Sponsorship opportunities
Gift cards
Complimentary/discounted event tickets
Other
What cities are you interested in Speaking?
*
Atlanta, GA
Savannah, GA
Nashville, TN
Birmingham, AL
Chicago, IL
Charlotte, NC
Raleigh, NC
South Carolina
Orlando, FL
Tampa, FL
Other
Phone Number
-
Area Code
Phone Number
Social Media Platforms
*
(Facebook, Instagram, LinkedIn and/or Other)
Address
City
State / Province
Postal / Zip Code
What is your area of expertise?
*
(Business, Leadership, Law etc.)
How long have you been speaking
*
0-1yr
1-5 yrs
5yrs or more
Would you pay to speak?
*
Yes, Move to next question
No, Skip to final question
If YES, how much?
*
$200 or less
$300-500
$500 or more
Other
If NO, What is your hesitation/reservation with paying to speak?
*
Type "N/A" if none
Submit
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