Speaker Application Form

Speaker's Name

Organization Name

Address

Website

Phone Numberoffice & mobile

Email Address

Please check your preferred format for your program:

In-personPhoneWebinar/Live Web Based

Are you credentialed through the ICF?

YesNo

If ‘Yes’, what credential do you hold?

ACCPCCMCCn/a

Have you ever presented to ICF or one of its chapters before?

YesNo

If “yes”, when, where and what was your presentation title:

PREPARING YOUR PROPOSAL:

1. Review the Speaker Submissions Guidelines (click on link for document)

2. Review the ICF Ethics & Regulations (click on link for document)

3. Review the ICF Core Competencies (click on link for document)

SESSION INFORMATION:

Session titles and descriptions are posted on the ICF Malaysia website. They are used for marketing communications so that attendees know what to expect from your session. Your presentation delivery should remain consistent with what you submit below. This information will assess appropriateness for our members and help us properly promote your event.

Session Title

Session DescriptionMin 150 Words - Max 250 Words

0 / 250

What problem(s)/challenge(s) will attendees learn to solve and how will this support their professional or business needs?

0 /

What will attendees learn? Please list 3 - 4 takeaways.

0 /

State the core competencies and resource development topics will be covered during your presentation and provide a brief explanation.Please note these will be used to apply for CCEUs. Review the ICF Core Competencies

0 /

Please provide a brief outline of your presentation.Interactive experiences are highly encouraged (dyad, triad or group exercises, role play, etc.) though not required.

Please indicate what you will require for an in-person presentation

ProjectorMicrophoneWi-Fi connectionFlip Chart(s)Participants to bring laptopTable for books, flyers, programs, etc. (sale items acceptable) Other

Any other information or needs not covered

Your Bio150-200 words with information that ties your presentation to your area of expertise

Upload File

Your PhotoAttach jpeg file

Upload File

Please list 3 references including their contact information

Reference Name 1

Reference Contact 1

Reference Name 2

Reference Contact 2

Reference Name 3

Reference Contact 3

How will you promote this program to your own contacts, fans and followers?

Links to a 5-minute video clip (YouTube, Video, your website, etc.) introducing your proposed topicif available

We want this to be a mutually beneficial opportunity. It is acceptable to make an offer for services or programs at the end of the presentation ONLY. For in-person chapter meeting, please let us know if you would like a table set up at the back of the room for any books, literature, etc., that you would like to put out (including items you have for sale). Many presenters offer a free gift drawing in exchange for business cards (though please mention when collecting them if you’ll be putting them on your mailing list).

Upon clicking 'Submit Form' above, you will be redirected back to the ICF Malaysia homepage. You will also receive an email with a PDF copy of the submitted speaker application.

To apply to speak, please fill in the form below.