Speaker Bio Submission - USED ON SPONSOR PORTAL DO NOT DELETE OR MODIFY

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X/Twitter

This field is for validation purposes and should be left unchanged.

Are you filling this form out for someone else?*

No, I'm the speaker.

Yes, I'm submitting a bio for a speaker other than myself.

Your Name*

First Last

Your Email*

Speaker Information

Name*

First Last

I'm speaking at:*

LWTSUMMT 2027

Will you be using slides/visual aid(s) for your presentation?*

Yes, I will use slides and submit them to you by May 7

No, I will not be using slides or visuals for my presentation

Company Name*

Job Title*

Email*

Cell Number*

Speaker Bio*

Photo*

Please upload a high-res, square image that's at least 500x500px.

Accepted file types: jpg, jpeg, png, gif.

Linkedin*

Please link to your personal LinkedIn profile.

X Handle*

If you're not on Twitter, write N/A

Instagram Handle*

If you're not on Instagram, write N/A

Assistant Name

Assistant Email

Assistant Phone

Best Cell Phone for Day of Logistics*

Race/Ethnicity*

Asian

Black/African-American

Indigenous/Native American

Latinx

Middle Eastern

Native Hawaiian/Pacific Islander

Person of Color

White/Caucasian

Other

I choose not to disclose

Other Race/Ethnicity*

Pronouns*

She/Her

He/Him

They/Them

She/They

He/They

Zee/Zir

Ey/Em

Other

I choose not to disclose

Other Pronouns*

Gender Identity*

Woman

Man

Transgender

Nonbinary

Gender Non-Conforming

Bigender

Cisgender

Gender Queer

Gender Fluid

Agender

Other

I choose not to disclose

Other Gender Identity*

Sexual Orientation*

Lesbian

Gay

Bisexual

Queer

Straight

Ally

Other

I choose not to disclose

Other Sexual Orientation*

T-Shirt/Hoodie Size

XXL

XXXL

Your Address*

Street Address City State / Province / Region ZIP / Postal Code Country

Agreement

Speaker Policy*

I have read the Speaker Policy.

Speaker Policy here: bit.ly/SPEAKERPOLICY

Summit Dates*

I understand I have to hold the following Summit dates - June 7th-9th (in-person), unless the LWT team has already confirmed a time with me.

Summit Registration*

Yes, I understand that if my company has 100 or more employees, we ask them to purchase a Leadership Experience Summit pass.

social*

Yes, I will do my best to promote #LWTSummit on social media.

privacy*

Yes, I understand that by speaking at LWTSUMMIT I am agreeing that my picture and bio will be listed for this summit and on your website and that future requests to have these removed will not be honored except for extenuating circumstances.

ACF LinkedIn

ACF Job Title

ACF Company

ACF Last Name

ACF Summit