Speaker Name*

Name Of Speaker Organization*

Speaker Email Address*

Phone Number*

How did you hear about The ROAR Virtual Conference 2.0 (ROAR)?*

What is the title of your proposed session? *

Please Select Which Role Best Suits Your Skill Set / Expertise*: (*)
Keynotepanelistsession / workshop leader5 Min. Inspirational SpeakerIce BreakerNo preference

What Would Your Session be Like - A Brief Synopsis*

What are the Main Takeaways for your Session/Panel Discussion?*

Please indicate Main takeaways from your session in 500 words or less.

Why are you interested in speaking at ROAR?*

Please indicate in 500 words or less why you would like to speak at ROAR?

Speaker Bio*

Attach CV*

High-Resolution Photo of Speaker*

Social Media Contact Information:*

Please list any personal websites and/or social media presence. Include the social media platform and all relevant usernames. e.g. Twitter: @riyhtmedia or http://www.riyhtmedia.com/ (500 words or less)