Application for CWSC Speakers Bureau

Thank you for your interest in the CWSC Speakers Bureau. Before completing this application, you must read the Presenter Agreement & Program Guidelines, and Hosting Organization Information.

The volume of information we receive from potential speakers may make it difficult to talk with each candidate personally. We ask that you complete the following application and email the requested materials and we will provide a response as soon as possible.

Please note the CWSC Speakers Bureau is just one of many volunteer, consulting or leadership opportunities available. See the About Us tab to discover more ways you can help remake the world.

First Name

Last Name

Title (e.g. Doctor, Imam, Professor)

Telephone

Best time to contact you (EST):

Your Website (if applicable)

Postal Address

Are you a published author (e.g. book, movie, music, other)

If yes, enter title, publisher, cataloging, serial number and link if title is online

Enter brief description of your title(s) for interested organizations or enter N/A.

Preferred presentation types (check all that apply):

Keynote Speaker

Panelist

Moderator

Media Interviews

Seminar Leader

Workshop Facilitator

Entertainer (Comedian, Musician or Other Performing Artist)

Preferred Region

Preferred State

Your Primary Preferred Topic

If you selected "Other," then list primary topic here

Your Secondary Preferred Topic

If you selected "Other," then list a second topic here

Enter here any other presentation topics you wish to appear on your speaker profile or enter “none”

Provide web link(s) to example(s) of your public speaking or enter "none"

Enter here your occupation(s) you wish to appear on your speaker profile

Do you have a written agreement for host organizations to sign when requesting you as a public speaker?

Brief Bio of 150 words or less

Enter brief 35 word or less snippet describing to organizations who you are and/or what you deliver as a public speaker.

Enter in 25 words or less an original quote or motto to appear on your profile or enter none.

Paste below full bio or enter online link to bio or enter none.

Have you emailed a professional headshot jpg photo to cwsconline@gmail.com?

Electronic Signature

One comment

selfcheckdaily
January 13, 2018 17:03

I give my best and appreciate this opportunity to become proactive member of CWSC.

Reply

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