District 25 Speakers Bureau Application
The District 25 Speakers Bureau needs the following information:
Your Name:
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Home Club Name:
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Home Club Number
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Home Address:
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Your Employer:
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Your Occupation:
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Your Home Phone Number:
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Your Work Number:
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Your Cell Number:
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Your FAX Number:
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Your E-Mail Address:
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Please list your hobbies:
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Highest Award in Toastmasters Received:
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Your Club’s VP of Education:
Community Speaking Engagements (Presentations given outside of Toastmasters)
Date
Name of Organization/Contact
Speech Length
1.
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2.
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3.
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Speech topics (Select a maximum of 5)
Advertising/PR
Arts/Music
Athletic Sports
Business
Careers
Coaching
Communications
Computers
Creativity
Customer Service
Diversity
Education
Empowerment
Family
Financial Planning
Future
Gender Issues
Government/Politics
Health
Humor
Internet
International
Gardening
Inspirational
Labor relations
Law
Leadership
Life
Experiences
Magic
Management
Marketing
Media
Medical/Dental
Motivation
Negotiation
Networking
Organizational Skills
Patriotic
Productivity
Psychology
Real Estate
Relationships
Religion
Retirement
Sales
Science/Engineering
Self esteem
Strategic Planning
Story Telling
Stress
Success
Substance Abuse
TQM
Team Building
Technology
Time Management
Training
Writing
Other
Define Other__________________________________________
Special Formats (Circle all that apply)
Announcer
Contest Judge
Emcee
SpeechCraft
Youth Leadership
Availability (Circle all that apply)
Weekday
Early morning
Afternoon
Week Evenings
Weekends
How far are you willing to travel?________________________________________________
Personal Bio (300 words
maximum)_________________________________________________________
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Special Thanks to D-53 and Jay Discount