Successful Speakers

Want us to represent you as a Speaker?

At Successful Speakers we are always interested in adding quality speakers to our talent bank. As you can
appreciate our clients and we demand high standards and as such we are unable to represent everyone who
would like to be with us.

To help us with our consideration we have provided below a form for you to complete. Once you have sent this
to us we will confirm receipt of the information by email and present it to our panel which meets
monthly to review opportunities.

We will respond to you within 6 weeks and may ask that you send a sample DVD of your presentation at that point.
So please complete the expression of interest form below.

Speaker Representation Application.

* Title

* First Name

* Last Name

* Email

* Phone business

* Mobile

* Address

* Suburb / City

* State

* Post Code

* Country

*Speaking Topic:

* Short Bio: (up to 200 words)

* Long Bio:

* Photo:
(A high resolution head and shoulders photograph should also be attached.)

(Picture size 108 pixels wide 153 pixels high)

* Gross Fee:

* Testimonial 1:

* Testimonial 2:

* Testimonial 3:

* Testimonial 4:

Website (if available)

* Further comments

* Verification Code (Please enter the verification code below.)

* Required fields