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Name*
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Website*
Email*
Business Phone*
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Business Address*
Street Address Address Line 2 City State ZIP Code
Speaker Information
Twitter handle:*
Number of Twitter followers:*
Facebook page address:*
Number of Facebook friends:*
Number of Facebook likes:*
Description of your proposed topic (100-200 words):*
Key points that the attendees will learn from your presentation:*
Speaker biography (200-500 words):*
Book Title(s) or articles you have written:*
Speeches/Keynote Video URL/Address:*
Stages/Events you have spoken from:*
By what quote do you live?*
By whom were you referred?*
Please provide a youtube URL of you speaking, or email a 5 min. or less video clip of you speaking to Info@SSLwomen.com*
By submitting this form you are certifying that all of the information provided, whether prepared by you or not, is complete and true in all respects. Submitting this form places your name into the pool of possible speakers that will be considered for the 2017 Suits, Stilettos and Lipstick Conference. Submitting this form does not guarantee a speaking position. Submission reviews will begin after May 6, 2017. Should we require more information, or if you are chosen to speak at the conference, you will be contacted via e-mail or phone by our Speaker Committee Chair.