Speaker's Bureau Speaker Application Title First Name * Last Name * Suffix Email * Phone Number * Business/Organization Name * Address Block - US Address Line 1 * Address Line 2 City * State * Select option... Alabama Alaska Arizona Arkansas California Colorado Connecticut DC Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming DC Zip/Postal Code * Are you a current member of the Lewisville Area Chamber? * Select option... Yes No Presenting Topics (Please list three): * Please provide a short professional bio (300 words or less): * Please highlight a few of your most recent speaking engagements in the last year (Please include topics, location (specify chamber/organization), # of attendees): * Do you charge a speaking fee? * Select option... Yes No If so, what is your fee?
