Speaker Info Collection

Thank you for accepting our invitation to speak
at the Coptic Conference on January 8th, 2022.

We just need a few details to proceed. Please fill out the form below with as much information as you can provide. If you have any questions, you may contact us for clarification or assistance.

Speaker Info

Basic Info

Full Name as you'd like it used for promotion

How would you like us to address you in our communication? (First name, title and last name, full name, nickname, etc.?)

Email Address

Promotional Photo

Choose Image

Mailing Address

Address Line 1

Address Line 2

City

State

Zip Code

Country

Phone Number

Social Security Number / Tax ID Number

If you feel uncomfortable entering that here, please call our office at (616) 531-1339.

Info on Your Presentation

Title of Your Presentation

Brief description of what will be covered in your presentation, and how the audience will benefit from it

Are you comfortable pre-recording your presentation?

Yes

Would you like help with pre-recording your presentation?

Yes

Preferred Time to do a presentation? (either live or for a recording)

Morning

Afternoon

Any time

Info to Help Us Promote You

Your Website (We will promote this before, during, and after our event)

For best results, this should be a link to a page offering a free gift in exchange for signing up for your mailing list.

Brief Bio (50 - 75 words. Will be used in email promotions)

Make sure to include credentials, such as number of books written, number of clients, celebrity clients, etc., as well as the primary benefit folks get when experiencing your products, services, or community. Your website URL will be added to this, so there's no need to include it here.

Longer Bio (200+ words to be used on a webpage devoted to promoting you on our website)

Any other comments you'd like to share (optional)

Key dates to keep in mind:

October 31st - Submit this form
November 15th - Event promotion begins
December 5th - Submit pre-recorded presentation and/or list of requirements for your presentation
January 8th & 9th - 2022 Coptic Conference Event

I agree to promote this event at least twice in the month preceding the event.

I have read and agree to the Speaker Agreement.

Thank you for accepting our invitation to speak at the Coptic Conference on January 8th, 2022.

Basic Info

Info on Your Presentation

Info to Help Us Promote You

Thank you for accepting our invitation to speak
at the Coptic Conference on January 8th, 2022.