ICF Toronto Speaking Request Form Speaker Information Question Title * 1. Speaker name and title Question Title * 2. Email address Question Title * 3. Phone number Question Title * 4. Website URL (if applicable) Question Title * 5. Speaker bio (300 words or less) Question Title * 6. Please provide references and/or links to recorded presentations Question Title * 7. Please select your credential (for coaches only) ACC PCC MCC Question Title * 8. Are you currently pursuing an ICF credential? Yes No Question Title * 9. Please indicate the URLs to your website and LinkedIn profile, if applicable. We will use these to tag you in social media posts when promoting your event. Presentation Information Question Title * 10. Date and time of presentation, per discussion with Learning & Development Director(s) Question Title * 11. Title of presentation Question Title * 12. Length of presentation (length is generally 60 to 75 minutes) Program Description / Learning Objectives Question Title * 13. Please provide a description of the program Question Title * 14. Please describe the learning objectives and specific subjects covered in this educational offering Question Title * 15. Please describe the level of interaction with the audience, for example, lecture only, Q&A, breakout room discussions, polls, etc. Question Title * 16. Please note which Coach Competencies are addressed, if applicable. Please click HERE to see the ICF Core Competencies Question Title * 17. What percentage of the educational offering time is devoted to training directly related to ICF Core Competencies (instruction on coaching skills or ethics, or applying technical skills or ethics, or applying technical skills as a coach)? 25% 50% 75% 100% Not sure Question Title * 18. Does the presenter(s) give permission to our chapter to record the presentation for chapter member access and viewing after the event? Yes No Question Title * 19. Would you be interested in submitting/writing articles for our coaching community? We would make these available for our members on our website Yes No If yes, please describe what you are interested in sharing/submitting Question Title * 20. Please upload your headshot and any additional information you would like us to consider. PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only. Choose File Choose File No file chosen Remove File Please upload your headshot and any additional information you would like us to consider. If you have any questions please contact info@icftoronto.com Done
