Speakers Bureau Listing Form

By completeing this form you agree to the following terms:

1. You are a current Toastmasters member in good standing of a club that is in good standing. Your dues are paid.

2. You have attained at least CTM status or accomplished at least 5 manual speeches within the Communication and Leadership manual OR have *paid* professional speaking experience.

3. You agree to NOT accept any form of payment (other than reimbursement of expenses or a donation in the fom of a check addressed to District 26 Toastmasters) for speaking engagements directly received through the D26 web site where you willl be introduced as or considered to be a representative of Toastmasters.

4. If you accept a speaking engagement, you agree to make that opportunity your top priority for the scheduled date. Even in the case of an emergency, you will make every effort to contact other members of the D26 Speakers Bureau to find a substitute speaker immediately.

5. You alone are responsible for making contact with the booking company or organization for any engagement, postpoinement or cancelation of any speaking engagements.

6. You agree to provide the D26 Speakers Bureau Chairman with written notice (by e-mail) of the date, location, time and contact for each speaking engagement booked as a result of the Bureau. This contact link will be featured on the D26 web site.

7. You agree to demonstrate professionalism and courtesy in all aspects of the planning and presentation process for speaking engagements.

8. You agree to show up on-time to all speaking engagements and to dress appropriately.

9. You agree to to mention Toastmasters somewhere in your presentation and direct audiences to the D26Toastmasters.org web site for more information whenever possible.

10. You agree to keep your contact information current by notifying the Bureau Chairman of any changes through the links provided on the D26 site.

11. You understand that District 26 and the D26 Speakers Bureau cannot guarantee that you'll EVER get a speaking opportunity through this system.

12. You agree to grant the D26 Speakers Bureau Executive Committee the complete authority to approve or reject your application for inclusion. In the event of rejection, you will be notified of specific reasons for disapproval.

13. You agree to grant the D26 Speakers Bureau Executive Committee the complete authority to terminate my membership if I am in violation of any of these terms.

It is this form that will allow us to quickly create a live posting for you. Please take some time to answer each question completely and accurately as we will be using this content for your official listing on the site.

Changes can be made to your individual listing by directly contacting NIck Samoylov, the D26 Speakers Bureau webmaster. Just fill out the contact webmaster form

Contact Information:
First Name:
Last Name:
Club Number:
(we only need one to verify membership)
Highest Level
Achieved in TM:
Your E-mail Address:
(Enter your e-mail only if you would like it posted on the site)
Your Day Phone Number:
(Enter your day phone only if you would like it posted
on the site)		 ()
Your Night Phone Number:
(Enter your night phone only if you would like it posted
on the site)		 ()
Enter Your Web Site URL
if you have a web site or page
where you will offer descriptions for "paid" speaking engagements.		 http://www.
Speaking Availability:
Number of miles you're willing to travel to speak:
Which city/town would you be traveling from?:
State:
How Far in Advance do you Require Bookings?:
Are you available for last minute fill-ins?:
What FREE presentation opportunities are you interested in pursuing?:
(Check all that apply)		 Topical Speeches related to my subjects
Serving as Master of Ceremonies
Parade Announcer
Carreer Day Speaker at a School
Keynote Speaker for an Event
Other Toastmasters Clubs and Events
Open to Other Opportunities
Preferred Speaking Days
(check all that apply):		 Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Preferred Speaking Times
(check all that apply):		 Mornings
Afternoons
Evenings
General Narratives:
Toastmasters Experience
(Please limit to 100 WORDS):
Speaker Bio
(Please limit to 150 WORDS):
FREE Speech #1 Information:
Title of Speech #1:
Usual Length (in minutes):
Can Length Be
Shortened or Extended?:
Description:
(200 characters or less please)
Main Topic Category:
Can this Speech Fit
Into a Second Category?:
Can this Speech Fit
Into a Third Category?:
Suggest a Category if not Listed:
FREE Speech #2 Information:
Title of Speech #2:
Usual Length (in minutes):
Can Length Be
Shortened or Extended?:
Description:
(200 characters or less please)
Main Topic Category:
Can this Speech Fit
Into a Second Category?:
Can this Speech Fit
Into a Third Category?:
Suggest a Category if not Listed:
FREE Speech #3 Information:
Title of Speech #3:
Usual Length (in minutes):
Can Length Be
Shortened or Extended?:
Description:
(200 characters or less please)
Main Topic Category:
Can this Speech Fit
Into a Second Category?:
Can this Speech Fit
Into a Third Category?:
Suggest a Category if not Listed:
FREE Speech #4 Information:
Title of Speech #4:
Usual Length (in minutes):
Can Length Be
Shortened or Extended?:
Description:
(200 characters or less please)
Main Topic Category:
Can this Speech Fit
Into a Second Category?:
Can this Speech Fit
Into a Third Category?:
Suggest a Category if not Listed:
FREE Speech #5 Information:
Title of Speech #5:
Usual Length (in minutes):
Can Length Be
Shortened or Extended?:
Description:
(200 characters or less please)
Main Topic Category:
Can this Speech Fit
Into a Second Category?:
Can this Speech Fit
Into a Third Category?:
Suggest a Category if not Listed:





Have a question about joining the Speakers Bureau?

Contact:
Nick Samoylov
nsamoylov@hotmail.com


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