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Speaker Agency Application

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Speaker Agency
Application

First Name

Last Name

Email

Phone

Social Media Links (Facebook, Twitter, etc.)

What is your speaking experience so far?

What is the main struggle or challenge that your message addresses?

What is a brief synopsis of your talk?

Please submit a full length talk video – otherwise please submit a 10 minute video of you sharing your message

(YouTube URL or similar)

If you have ever been published before, please provide details:

If you have given any talks elsewhere, please describe:

What would you say are your speaking aspirations?

What would you consider your dream places to speak?

What is it you want to see happen for others as a result of sharing your message?

Have you done any of KC’s programs or private client work in the past? If so, which ones?

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