POMA Outdoor Speakers Bureau
New Speaker Application

Your First Name:  

Your Last Name:  

Your Company Name/Affiliation:  

Address:  

City:  

State/Province: 

Postal Code:  

Country:  

Phone, work:   

Phone, home:  

Phone, cell:  

Your E-mail:   

Nature of your Business:

Speaking History (3 years):

Please provide reference and contact information for your last five speaking engagements:

Your topics/titles/seminar length:

What is your core message?

Do you use AV in your presentation?  If yes, explain?

Do you have audio/video recordings of prior engagements?
Yes     No

What is your fee range?   

Is the fee range   Net   or   Gross?

Applicant Acknowledgement:

Enter your name as verification of the acknowledgement below:

I understand my application will be reviewed by the Speaker Review Committee for approval. I also understand that may be asked to provide additional information and/or submit an audition tape for consideration.

Application processing normally takes approximately two weeks. A POMA Outdoor Speakers Bureau representative will contact you with the committee’s determination.

Thank-you for your interest in the POMA Outdoor Speakers Bureau