ApplyIf you would like to be considered for one of our Bosspreneur® Premier Speaker positions, please complete the following application.Name* First Last Company*Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSaint MartinSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country Email* Website* Facebook URLTwitter HandleAre you currently a member of Bosspreneur Business Circle?*Yes, I am an active BBC memberNo, I am not currently a member of BBCNo, not currently but I was a former memberNo, but I plan to become a memberNoOther(Note: you are not required to be a member of BBC)Please Specify:What Chapter city do you currently attend?Please list any speaker training from organizations or universities:*Have you performed at least 200 hours of speaking for clients?*Yes, I have performed 200 hours or more speakingNo, I have not yet completed 200 hours of speakingTell us about your background and your speaking experience:*Do you have an area or speaking niche that you specialize in?*YesNoPlease explain your area of speaker specialization:Please provide a brief explanation for why you want to be considered as a Bosspreneur® Speaker:*What percentage (%) of your speaking do you receive a speaker fee?*100%75%50%25%0%What percentage (%) increase in new speaking business would you like to see?*I can handle a 100% increase in new speaking business75% increase50% increase25% increaseOtherPlease explain:Please check all that apply to you below:* I currently offer 1 free initial coaching session I currently offer 2 free initial coaching sessions I do not offer any free coach sessions Did someone recommend you to become a Bosspreneur® Speaker?*YesNoIf yes, please provide their name:ReferencesPlease provide three (3)speaker client references in the last 12 months:Name* First Last Address* City State / Province / Region Email* Phone*Name* First Last Address* City State / Province / Region Email* Phone*Name* First Last Address* City State / Province / Region Email* Phone*Bosspreneur® Business Circle Speakers If you are accepted as a speaker for the Bosspreneur Business Circle you will be required to pay an annual marketing and promotion fee. The fee is $897 for Non-Members and $697 for BBC Members. Speaker Benefits Speaker profile listed in the speaker marketplace on BBC for clients to find you. One (1) registration for the International Conference & Business Expo, including Pre-Conference Bonus events Introductory video on your Bosspreneur® Speaker profile page Special Meet-and-Greet at Conference for speakers, coaches, and chapter directors Premier Bosspreneur® Speaker profile listed on BBC website Special Bosspreneur® Speaker emblem for use on website and marketing materials Picture, name and coaching specialty featured in Conference Program Guide Quarterly featured articles on the BBC blog, written by you! Blog articles promoted and showcased on BBC Facebook page and Twitter Spotlighted on main stage jumbo screens at the International Conference Personal endorsement group email from Becky to the BBC database If you are chosen as a speaker, you will be notified within 7 days, and will need to make your payment to become active.