Speaker Form

First Name

Last Name

Email Address

Phone Number

Company Name

1. Are you an ebooksentrepreneur.com customer?

Yes

2. Select the Purchased Product Category: It is okay that you may be a speaker for a different topic or category.

3. Mark ALL that applies to you:

If selected this is my First Time speaking or being an Interviewee

If selected this is my First Time being a paid Speaker or Interviewee

If selected this is NOT my First Time Speaking

If selected this is NOT my First Time being a paid Speaker or Interviewee

Since this is NOT my First Time, I have attached my Speaker resume below

4. Are you willing to work with a videographer?

Yes

5. Do you consider yourself an experienced speaker?

Yes

6. Do you understand this is a professional speaking opportunity and topics are regarding Business or Entrepreneurship?

Yes

7. Are you willing to sign a Non-Disclosure Agreement?

Yes

8. Are you willing to submit a professional photo with your submission?

Yes

9. Are you willing to prepare business material, outline, or notes for a speaking opportunity?

Yes

10. Are you willing to sign a Direct Deposit form or Consent form to be to be paid electronically?

Yes

11. Are you willing to travel?

Yes

12. Which platform are you interested in being a paid Speaker? Check all that apply.

In-Person

Virtual (Webinar, Conference, Social Media Interview)

Prerecord with personal device (ebooksentrepreneur.com will professionally edit)