Sarpy Chamber Speaker Form

Sarpy Chamber Speaker Form

If you are interested in being a speaker for one of our groups or events, please fill out this form. Speakers will be selected based on a variety of topics, qualifications, availability. Speakers will be notified 90 days prior to the presentation. The chamber will create and provide all marketing for the presentation, speakers will be asked to provide all content for selected presentation including any handouts needed. Speakers may submit up to 3 different presentations each year. If not selected, they may submit again the following year.
Name

First Name *

Last Name *

Current Title with Company *

Contact Info *

Company Name & Contact Information (including your direct report) *

Years with Company *

Topic & Experience *
Please describe what topic you are interested in speaking on as well as your years of experience with the topic and any related credentials.

Years of Chamber Membership *

Presentation Category *
Please select the category that best describes the presentation you're submitting.

Other Topic Specification
If you selected "Other" under Presentation Category, please describe it here.

Please provide a one-page summary of your presentation *

What is the desired outcome or take-aways of your presentation? *

Please provide 3 references that can speak to your presentation or credentials regarding your topic: *

Vendor Neutral Agreement *

I have read and agree to the Vendor Neutral Agreement

The purpose of Sarpy Chamber presentations is to provide content that the members/audience can implement or benefit from without purchasing a specific product or service. Your presentation must be free from all sales pitch or sales-related material, with exception to mention of the presenters current company or work related experience.

Radius Protection Agreement *

I have read and agree to the Radius Protection Agreement

I agree that I will not provide the same or similar presentation to an audience within Sarpy County or the Greater Omaha Metro within 3 months prior to, and 3 months after the scheduled Sarpy Chamber event.

Copyright Agreement *

I have read and agree to the Copyright Agreement

I agree that all content provided in this presentation adheres to copyright or intellectual property laws. I agree that I am solely responsible for content provided and release the Sarpy Chamber and its employees of any action that may occur as a result of failure to comply.
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Refunds for credit card payments will be issued as a check paid to the company under which the registration was made. A 10% processing fee will be deducted from the refund amount.

Upcoming Events

Refunds for credit card payments will be issued as a check paid to the company under which the registration was made. A 10% processing fee will be deducted from the refund amount.

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