Sponsor Speaker Confirmation Please list the speaker’s Name and Short Title exactly as it should appear. This information will be published as written in all Conference materials. Speaker Name(Required) Prefix Dr.Prof.Rev.Other First Last Phonetic Pronunciation of Name(Required)PronounsShort Title(Required)Organization(Required)Speaker Cell Phone(Required)CFW documents a cell phone number for every speaker in case of delays, emergencies, or urgent updates.Speaker Email(Required) Secondary Contact NameSecondary Contact Email Secondary Contact PhoneShort Bio(Required)Paste in Short Bio with a word count between 150-200 words. This information will be published as written in all Conference materials.Headshot(Required)Please upload your current headshot to be used on our website and app.Max. file size: 19 MB.Relevant CFW Markets(Required)Select all markets that apply. California Massachusetts Pennsylvania Texas National Conference (virtual) Speaker Classification(Required) Sponsor Board Member Community Partner In-Kind Sponsor Media Partner Speaker Role(Required)Select all that apply Keynote Intro/Remarks Executive Mentor Moderator Host Panelist Thought Leader Learning Stage Wellness Stage VIRTUAL- Keynote Intro/Remarks VIRTUAL- Host VIRTUAL- Executive Spotlight VIRTUAL- Learning Burst Please provide 2-3 questions you are comfortable answering during the live panel discussion onsite(Required)Each panelist brings a unique and different perspective to the session. Please provide 2-3 questions you are comfortable answering during the live panel discussion on site prior to audience Q&A. Please refer to the panel title and description to align your questions with the session scope. Questions can be adjusted after the Panel Prep Call, however, it is helpful for the Thought Leader to gain an understanding of your focus in advance so she/he/they can plan and facilitate the discussion accordingly.Prep Call Availability(Required)Please enter 3 dates/times you are available in the next two weeks for a prep call.Book TitleIf speaker has authored a book, please provide the title(s).(1) minute of remarks(Required)Session Hosts give (1) minute of remarks on behalf of your company prior to introducing the session/speaker onsite. Remarks must be nonpartisan, avoid sales focused messaging, stay within the time allotment (~140 words) and be reviewed and approved in advance by the Conference Team. Please provide a draft of your remarks. *Host Scripts will be emailed ~2-3 weeks before the Conference and will include your approved remarks with pre-approved language to introduce the session/speaker.(1) minute of remarks(Required)Session Hosts give (1) minute of remarks on behalf of your company prior to introducing the session/speaker onsite. Remarks must be nonpartisan, avoid sales focused messaging, stay within the time allotment (~140 words) and be reviewed and approved in advance by the Conference Team. Please provide a draft of your remarks. *Host Scripts will be emailed ~2-3 weeks before the Conference and will include your approved remarks with pre-approved language to introduce the session/speaker.Will you be attending one of our 4 live conferences?(Required) Texas Pennsylvania Massachusetts California N/A Would you like to be filmed with our professional film crew on site?(Required) Yes No, I’d prefer to record myself virtually” Recording InformationPlease identify 3-4 dates/times that you are available to dedicate a maximum of 60 minutes to record this session within the next 30 days, but no later than December 15th, 2025. We will work with the producer's calendar to select one time for recording. Calendar invite to follow.(Required) Add RemovePlease identify 2-3 dates/times you are available for a 30 min prep call at least a week prior to your recording availability. This prep call will be with you and the CFW Program Director. Calendar invite to follow.(Required) Add RemoveRecording Equipment Needs(Required)In order to ensure the highest quality video, we require the following equipment be used during your session recording. Please select below which item(s) you would need for us to send to you. Ring light (or other professional quality lighting) Ethernet Cable (Speakers should be within 50ft of their router to use an ethernet cable during the recording) All of the above. None of the above. I have all these items. 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