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Executive Women International - Membership Application
EWI Speakers Bureau Application
The EWI Speakers Bureau is a free service for EWI Members.
If you are an EWI Member, please
log in
to the EWI web site to submit your Speakers Bureau application. If you are not an EWI Member, you can still participate in the Speakers Bureau for an annual fee of $100.
Please complete the following form to submit your application.
First Name:
Middle Initial:
Last Name:
Title:
Company Name:
Address 1:
Address 2:
City:
State/Province:
Alberta
Alaska
Alabama
Arkansas
Arizona
British Columbia
California
Colorado
Connecticut
Canal Zone
District of Columbia
Delaware
Florida
Georgia
Guam
Hawaii
Iowa
Idaho
Illinois
Indiana
Kansas
Kentucky
Louisiana
Labrador
Massachusetts
Manitoba
Maryland
Maine
Michigan
Minnesota
Missouri
Mississippi
Montana
New Brunswick
North Carolina
North Dakota
Nebraska
Newfoundland
New Hampshire
New Jersey
New Mexico
Nova Scotia
Northwest Territorie
Nevada
New York
Ohio
Oklahoma
Ontario
Oregon
Pennsylvania
Prince Edward Island
Quebec
Puerto Rico
Rhode Island
South Carolina
South Dakota
Saskatchewan
Tennessee
Texas
Utah
Virginia
Virgin Islands
Vulcan
Vermont
Washington
Wisconsin
West Virgina
Wyoming
Zip/Postal Code:
Phone
(
)
-
Fax
(
)
-
Email:
Website:
http://
Speakers Bureau
Brief Bio:
(100 words max.)
Program Topics
(Hold ctrl + click to select multiple)
Communication
Generations
Leadership
Managing
Negotiations
Public Speaking
Team Building
Volunteer Management
Please provide Name, Phone Number and/or Email addresses for three (3) references:
EWI Chapters you have presented for:
(Hold ctrl + click to select multiple)
Albuquerque
Atlanta
Baton Rouge
Birmingham
Boise
Calgary
Charlotte
Chattanooga
Chicago
Cincinnati/Northern Kentucky
Colorado Springs
Columbus
Corporate
Corpus Christi
Dallas
Dayton
Denver
Des Moines
Detroit-Windsor
Fort Wayne
Grande Prairie
Hampton Roads
Harrisburg
Honolulu
Houston
Huntsville
Indianapolis
Jackson
Kansas City
Kentuckiana
Knoxville
Lehigh Valley
Lethbridge
Little Rock
Long Beach
Los Angeles
Member-at-Large
Memphis
Milwaukee
Minneapolis
Mobile
Montgomery
Nashville
New Orleans
Northwest Arkansas
Oklahoma City
Omaha
Orlando
Philadelphia
Phoenix
Pittsburgh
Pomona Valley
Portland
Richmond
Roanoke
Rochester
Saint Paul
Salt Lake City
San Antonio
San Diego
San Fernando Valley
San Francisco
Seattle
Shreveport-Bossier City
Spokane
Tacoma
Tampa Bay
Tucson
Tulsa
Washington DC
Wichita
Speaking opportunities of interest:
Please check the box next to the speaking opportunities that are of interest to you, and enter your fee range for that type of engagement.
Type:
Fee Range
Career Tracks at the Leadership Conference and Annual Meeting
Presidents Caucus
Academy of Leadership
Teleseminars
Professional Development for local chapters
Indicate Area Preference :
(Hold ctrl + click to select multiple)
Albuquerque
Atlanta
Baton Rouge
Birmingham
Boise
Calgary
Charlotte
Chattanooga
Chicago
Cincinnati/Northern Kentucky
Colorado Springs
Columbus
Corporate
Corpus Christi
Dallas
Dayton
Denver
Des Moines
Detroit-Windsor
Fort Wayne
Grande Prairie
Hampton Roads
Harrisburg
Honolulu
Houston
Huntsville
Indianapolis
Jackson
Kansas City
Kentuckiana
Knoxville
Lehigh Valley
Lethbridge
Little Rock
Long Beach
Los Angeles
Member-at-Large
Memphis
Milwaukee
Minneapolis
Mobile
Montgomery
Nashville
New Orleans
Northwest Arkansas
Oklahoma City
Omaha
Orlando
Philadelphia
Phoenix
Pittsburgh
Pomona Valley
Portland
Richmond
Roanoke
Rochester
Saint Paul
Salt Lake City
San Antonio
San Diego
San Fernando Valley
San Francisco
Seattle
Shreveport-Bossier City
Spokane
Tacoma
Tampa Bay
Tucson
Tulsa
Washington DC
Wichita
Please enter a username and password. Once your application is accepted, you will be able to log on to the EWI web site to maintain your profile information.
Web Site Login:
Password:
Confirm Password:
Press the 'Submit' button to submit your application.