SPEAKER PROPOSAL FORM
Please refer to Speaker Proposal Submission Guidelines for information on what is to be included in submission of each in-person meeting and webinar. A separate speaker proposal form is requested if you wish to submit for both an in-person and webinar event.
A. GENERAL INFORMATION
2. Business Name:
3. Email Address:
5. City/Prov/Postal Code/Country:
6. Phone: Cell:
7. Short description of your business mission/purpose (in 5 or 6 sentences):
8. Are you a member of the International Coach Federation? Yes No (please underline answer)
9. Please indicate your ICF credential status: ACC, PCC, MCC (please underline one) or, not pursuing an ICF credential at this time (please underline if this is your situation)
10. Have you ever presented for the International Coach Federation? Yes No (please underline answer) If “yes”, how many times?
11. What venues/occasions did you present for ICF? (please include titles)
12. Please indicate if you previously received ICF approval for CCEUs for your proposed presentation.
B. PRESENTATION INFORMATION
We are looking for dynamic speakers with programs that are inviting and that also challenge our thinking. Please complete this section as completely as possible so we can evaluate how this proposal meets our needs.
1. Presentation title.
2. Presentation description.
3. Please describe the specific subjects that will be covered in this educational offering.
4. Please list at least three takeaways. (e.g., In this session you will learn how to…; or, After attending
this session you will be able to…)
5. Describe how attendees can apply this session to their interactions with clients.
6. Describe the interactive activities you will include in this presentation.
7. Describe your qualifications to speak on this topic.
8. Describe how your presentation aligns with the strategic goals of our chapter.
C. PERSONAL AND PROFESSIONAL INFORMATION
1. Your Bio (Please write 100-300 words with information that ties your presentation to your area of expertise – attach separately, if necessary):
2. Your Photo (Please attach a jpeg file):
3. Please identify several different months in the upcoming calendar years (2017/18) in which you can be available for either:
a. An In-Person meeting/workshop
b. A Webinar (typically 60-90 minutes)
4. For an in-person event, please indicate what audio/visual equipment you may require.
5. For a webinar, please indicate if you have a Zoom Meeting account.
Please refer to our Speaker Proposal Submission Guidelines document.
Please email this completed document to our Events Director: firstname.lastname@example.org
Thanks for supporting our ICF Vancouver Island chapter!