The Chamber of Commerce for Greater Philadelphia

Speaking Opportunities

Speaker Submission Form

Please complete the following form if you wish to be considered for the Speakers Bureau. Entries that go over the specified character limits will be cut off.

First Name*:

Last Name*:

Title*:

Company Name*:

Company Address*:

City*:

State*:

Zip Code*:

Email*:

Business Phone*:

Website:

Program Details

Past Speaking Venues*:
(Please limit response to 800 characters and separate venues with a semi-colon)
Characters Remaining: 800

Speaking Topic*:
(Please limit response to 80 characters)
Characters Remaining: 80

Your desired type of speaking engagement:
(check all that apply)

Educational

Young Professionals

Roundtable/Panel Discussion

Industry Specific

Doing Business With Large Companies

Please limit your responses to each question below to 450 characters.

By the end of the session, participants will*:
Characters Remaining: 450

Benefits for participants*:
Characters Remaining: 450

What visual aids will you use?
(check all that apply)

Handouts	Video
Overheads	PowerPoint Presentation
Slides	Other

Program Duration*:

Credentials

Have you presented a program for the chamber in the past?

Yes, I have

Please list three (3) professional references*:
(limit response to 250 characters each)
Characters Remaining: 250
Characters Remaining: 250
Characters Remaining: 250

Please upload a biography (in Word or PDF formats):

Please upload a headshot
(in JPG or GIF formats):
All images will be resized to 100x100 pixels.