Speaker Interest Form

Speaker Information
First Name*
Last Name*
Company*
Email*
Address
Address 2
City
State
Zip
Country
Office Phone*
Mobile*
Website*
Picture
Speaker Bio*
Are you familiar with the 4 tenets of Conscious Capitalism?*
If Yes, which tenet(s) do you think your presentation can most highlight?
Presentation Information
The title of your session is the first impression for Event Attendees. Use a concise, but inclusive, title which clearly conveys what you will be presenting and draws attendees' attention to your topic.
Title of Your Session*
Your session description will tell Event Attendees why they should attend your presentation. To be effective and create interest, it should provide a brief, clear, and concise reflection of your presentation’s content. It should highlight the key take-aways for attendees. The description should only be one paragraph between 100 to 150 words in length.
Description*
AV Specifications
Will you be bringing your own laptop or will you need one provided for you?*
If bringing your own, which type is your laptop?
Please inform us of any dietary needs, allergies, or other special requests necessary for planning purposes.
Special Requests
Handouts & Materials for Attendees
All presenters will be responsible for bringing copies of any handouts/materials they have for attendees. You will receive registered attendance numbers 1 week ahead of the event so that you may plan and prepare accordingly.

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Speaker Information