Speaker Registration Form

Thank you for your interest in becoming a speaker with the Blue Light Speakers Agency (BLSA).

At BLSA we believe in promoting the best of the blue light services and our mission is to provide high quality, knowledgeable and experienced blue light personnel with the platform to communicate important, inspirational messages to a wider audience. In doing so we increase accessibility to a diverse range of remarkable speakers for public and private sector bookings.

Contact Details

Prefix

First name

Last name

Post Noms

Preferred Pronouns

Email

Phone

Correspondence Address

Company name

Position within the Company

How did you hear about us:

To provide the best opportunity to share your experience and speaker offering, please be expansive in filling out each section

Please provide a short title to capture your speaker profile.

Please indicate which categories you are able to cover:

With reference to the above, what are the keynote themes, including titles, of the subjects you are able to speak about?

Please indicate which Speaker types you are interested in:

Speaker experience and highlights

Please detail previous speaker engagements and experience, including topics of interest in up to 200 words.

Please provide a short biography, including career accomplishments in up to 400 words.

Please indicate your preferred hourly rate and/or rate per event type.

Please provide any relevant testimonials.

Please indicate if you are interested in participating in a short podcast to promote your profile to clients.

Yes

No

Unsure - please email me with more info on this

Please indicate if you are also interested in providing consultancy services.

Yes

No

If yes - please specify your day rate:

Please email info@bluelightspeakersagency.com with 2-3 photos, which must include a head shot, plus, if available, an edited showreel.

Register to be a speaker with us

Speaker Registration Form

Contact Details

To provide the best opportunity to share your experience and speaker offering, please be expansive in filling out each section

Speaker experience and highlights

Blue Light Speakers Agency