Event Bio Request

Speaker Central Form

Your Name*
Headshot (minimum 400px wide)*
Brief Bio*
Display First Name*
This is what will be displayed as your first name.
Display Last Name*
This is what will be displayed as your last name.
Title
(Founder, Owner, etc.)
Twitter Handle*
Facebook URL
The URL to your facebook page.
Website URL*
Start with www (leave off the http://)
Website Name*
Additional Website URL (optional)
Start with www (leave off the http://)
Additional Website Name (optional)
Acknowledgement*
- I understand that I need to bring my own laptop and any special Mac adapters as needed for my presentation.
Speaker Contract:*
We’ve provided some specific guidelines to which you will give your commitment by agreeing below. This will serve as the agreement between speaker and Digital Colab Media LLC. No other agreements will be issued. SPEAKER OBLIGATIONS: In addition to speaking, all speakers, moderators, experts, and panelists are expected (a) attend the entire Success Incubator event, to be held on Tuesday, October 24, 2017, to midday Wednesday, October 25, 2017. SPEAKER TRAVEL AND COMPENSATION: Speakers are responsible for booking their own travel and accommodations. Compensation will consist of the following: Main Stage and Power Session Speakers will receive a complimentary Success Incubator Pass ($550 total value). Table Leaders will receive a 50% discount on their Success Incubator pass ($275 value). If you have previously purchased a pass, we will issue refunds by September 31, 2017. OTHER IMPORTANT CONDITIONS: By agreeing to speak at Success Incubator, you are granting Digital CoLab Media the right to use your name, image, bio and topic information in the promotion of the show and your session. This includes listings in the web site, promotional mailers/e-mails/newsletters, advertisements, the show directory/addendum and various other sources as to be determined by the Success Incubator organizers. Digital CoLab Media LLC shall have the right and royalty-free license to sell or to produce and show a tape-delayed broadcast of the speaker’s session, or to the public generally, through streaming Internet video or DVD. There is to be absolutely, positively no selling by speakers. Educate the audience; do not sell to them. Impress attendees with your knowledge and they will seek you out. Self promotion is prohibited. Also, there are to be no political discussions or jokes and no foul language from speakers. If that is a problem, please do not confirm this agreement. This Agreement shall in all respects be governed by and construed in accordance with the laws of the State of Texas. Please complete the fields below and confirm your agreement to the terms before you proceed to the rest of the submission form:
Electronic Signature:*
By printing your full name here you are indicating that you agree to the above terms and conditions.