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Speaker Registration

Thank you for wanting to be a speaker at our event.  We want to represent you in the best way possible.  And in order to do that, we need more information about who you are.  Try to provide as much information as possible.  And thanks again.

  • This will be published on the page you will be featured on as a way to contact you.
  • This will be published on the page you will be featured on as a way to contact you.
  • This will be published on the page you will be featured on as a way to contact you.
  • Give your topic a title. This information will be published.
  • Tell us a bit more detail around what you are going to talk about. This information will be published as a preview to your video. Limit 1000 characters.
  • Please list 6-8 questions you'd like me to ask you.
  • Fill out this box with information regarding who you are. This information WILL be published on the page that will feature your video. Please be descriptive and use this area to really sell what you are talking about and/or offering. Limit 2000 Characters.
  • Accepted file types: jpg, png.
    Please upload a professional high quality headshot. Must be saved as a PNG or JPG file and not exceed 2MB in file size.
  • Accepted file types: jpg, png.
    If you have a brand or logo that you would like to present, please upload the logo here. Must be saved as a PNG or JPG file and not exceed 2MB in file size.
  • If you are offering a free gift, please provide the URL where a customer will receive the gift.
  • Please enter a title of your gift. Such as "101 Basic Health Guide" or "Ways to Motivate Energy". We will add the word "Free" in front of what ever you put.
  • Really sell your gift and why the customer would want it. Limit to 1000 characters.
  • This information WILL NOT be published.