First Name
Last Name
Phone
*
Email
*
Organization
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Website
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LinkedIn Profile
Your Title/Role
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Proposed Topic / Presentation Title:
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Brief Description of Topic (2–4 sentences):
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Key Takeaways (3–5 points):
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Target Audience
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Business Owners
Leaders/Managers
Entrepreneurs
General Community
Presentation Format
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Keynote
Workshop
Panel
Fireside Chat
Briefly describe your Christian faith and how it influences your work:
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How does your presentation align with biblical principles?
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Prior Speaking Experience (events, podcasts, workshops, etc.):
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Links to Sample Talks (YouTube, podcast, etc.):
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Preferred Event Type:
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In-person workshop/event
Online workshop/event
Conference
Ribbon Cutting / Open House / Host a Mixer at Your Location
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Will you have promotional materials/links available for PACCC use?
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Are you planning to offer a product or service at your event/presentation? If son, please describe:
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Please provide a short bio or a link to your bio:
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Please provide one reference (event organizer, pastor, business leader, etc.) and their contact information:
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I confirm that the information provided is accurate and agree to present content honoring biblical values and appropriate for a Christian business audience. I understand that submitting this application does not guarantee selection.
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