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District 60 Speakers Bureau - Speaker Registration

 

First Name:     Preferred Name or Nickname:
 
Last Name:  
     
Email:  
District number: To stop spam, please enter district #
Address line 1:
 
Address line 2:
 
City:  
     
Work Tel#:    Cell/Home Tel#:  
     
 
Main Toastmasters Club #:   Club Name:
 
Highest Toastmasters Designation Achieved:        		 
Highest Toastmasters Contest Award Achieved:  
 
     
Occupation:    Employer:  
 
Other Accomplishments, Hobbies or Special Interests:
  
 
Daily Availability - pick one for each day
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
 
Preferred Geographic Area:  
Will you serve as club guest speaker ?    
Will you serve as evaluation contest "test speaker" ?  
 

Types of Services you can offer - check any you are ready to do:

Speech      Workshop      Speech Writer      A/V Presentation      Master of Ceremonies      Public speaking coach   
  

 

Speech Types you can deliver:

Informational     Humorous     Entertaining     Inspirational / Motivational     Workshops (interactive)

Other:

TOPICS YOU SPEAK ON

Which topics can you speak on?   Please check only those which “truly” apply to you and which you are ready to speak on:
Aging Fitness Social Media
Achievement/Goal Setting Grief or Adversity Stress Management
Business Etiquette Happiness Personal Development/Improvement
Business / Economy Humour Sales
Career Transition Innovation Science/Technology
Change Management Internet Storytelling
Childre/Child Development Interpersonal Communication Personal Finance
Computers / Internet Interpretive Reading Poetry
Conflict Resolution Leadership Presenting with Power Point/Keynote
Customer Service Life Balance Public Speaking
Dating Management Skills Team Building
Education/Teaching Marriage Time Management
Health Mathematics Volunteering
History Nutrition Weight Loss
Other topics you can speak on (if not listed above):
 
 
 
Link to video of you speaking (e.g. a YouTube 'share' link):    
Link to your speaking website:    
 

DETALS OF YOUR SPEECHES AND PRESENTATIONS
 
Speech presentation #1 which you are prepared to present
Title:
     
Subject:
     
Summary:
   
Duration:
Minimum time:
minutes		 Maximum time:
minutes		 Average time:
minutes		 Can expand to:
minutes
Speech presentation #2 which you are prepared to present
Title:
     
Subject:
     
Summary:
   
Duration:
Minimum time:
minutes		 Maximum time:
minutes		 Average time:
minutes		 Can expand to:
minutes
Speech presentation #3 which you are prepared to present
Title:
     
Subject:
     
Summary:
   
Duration:
Minimum time:
minutes		 Maximum time:
minutes		 Average time:
minutes		 Can expand to:
minutes
Notes:
   
 
 

REFERENCES


Each Speakers Bureau candidate must provide 2 references who will be contacted about you and your speaking.
Reference 1
        
Name:
 
Contact Information:
 
   
Reference 2
  
Name:
     
Contact Infomation:
 

DISTRICT 60 SPEAKERS BUREAU TERMS AND CONDITIONS

Speaking Engagement Requirements:
  • The Speech given shall be commercial free.
  • A speaker can accept small gifts or dinner from an organization but cannot accept any monetary compensation.
  • All money must be sent to Chairman District 60 Toastmasters Speakers Bureau to be placed in the District Treasury.
  • In addition, speakers should be prepared to briefly describe the Toastmaster Organization.
Each speaker must:
  • Be a Toastmaster in good standing
  • Agree to be contacted directly by organizations seeking speakers
  • Provide bio, image and link to a video of delivering a speech/presentation for the Speakers Bureau Web site
  • Provide good contact information
  • Respond in a timely manner when contacted by organizations
  • Report back to the bureau after each speaking engagement
  • Provide the organization with an evaluation form to be sent back to the bureau
    •

    I hereby agree to the above requirements and terms, certifying that the information provided herein is true and correct.  
    I understand that by submitting my personal information in this form, I give District 60 Toastmasters and its Speakers Bureau permission to publish it in the District 60 Speakers Bureau directory and searchable by the public.
     
     
     
    Have a question or experienced a problem submitting this form? Email Fraser at speakersbureau@toastmasters60.org.
     
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