Program Proposal Form Fields marked with an * are required. Please verify that you have checked the “I'm not a robot” checkbox. Ok Page 1/4 Contact Information First Name * Last Name * Please share your preferred pronouns she/her he/him they/them ze/hir Email * Position/Title * Page 2/4 Company Information Company Name * Is this company a member of the Chamber? * Enter required value Yes No Please upload your company logo (jpg or png format) * 20MB max Phone * Website Page 3/4 Presentation Information Presentation Title * Briefly describe your topic * Program Outline (content, interactive component, and learning objectives) * What are three key objectives that participants will learn by attending your presentation? Label 1. 2. & 3. in response Does your presentation require a maximum number of attendees required based on the content/format? * Enter required value Yes No How long is your presentation (including any Q&A)? * Describe Your Marketing Plan (how will you promote to your network and encourage participation?) * What content have you used to promote your presentation to encourage the highest number of attendees * Speaker's Bio (Brief; one marketing paragraph only. Upload full bio below.) * Form - Please upload speaker headshot (jpg or png format) * 20MB max Describe Experience as a Presenter in the Proposed Topic Area * Describe how YOU will benefit by presenting * Suggested Presentation Format * Please indicate the time/format you feel would best fit your program; morning, mid-day, or after-hours. Morning: 8:30 - 10:00 AM Lunch: 11:30 AM - 1:00 PM After Hours: 4:30 - 7:00 PM What types of A/V equipment or other materials are needed? * What type of room layout is ideal for your presentation? Theater Style Classroom Style Table Rounds Do you have a specific location in mind? * (Note: Generally, programs will be held at different Chamber member locations or other locations approved by the Chamber.) Yes No If yes, what specific location are you recommending? Will you sponsor the event? * (sponsorship may include food & beverage, parking, etc.) Yes No Please share any comments about sponsorship of the event. Optional Document Upload You may upload any handout materials, full bio, professional resume, etc. 20MB max Optional: Video Link If you have a video you would like us to view, please enter the URL here. Page 4/4 Company Information Facebook Instagram LinkedIn Twitter Provide Three Professional References (Specify the context in which the references know you and are familiar with your skills as a workshop presenter or speaking on this topic. You may provide a link to a video of a prior speaking engagement if applicant) Reference 1 - Name; Phone; Email * Reference 2 - Name; Phone; Email * Reference 3 - Name; Phone; Email Powered By GrowthZone
