Speaker Basic Information
I'm so excited that you're going to be a speaker at this year's Neurodiverse Entrepreneur Summit! This quick form will give us everything we need to get your information added to the summit's website.
๐จ DEADLINE: May 6th (but the sooner, the better)
Write your name exactly as you'd like it to appear in all summit promotion materials and on the website
eg. she/her, they/them, he/him, she/they, etc
Email address you'd like me to use for speaker updates
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Where do you like to DM?
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This is handy for quick questions and follow ups
"Job Title" that demonstrates your expertise
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This will be included in summit promotional materials. If too long, we will shorten it.
Ex. Brand Designer, Business Coach, Content Strategist, ADHD Content Creator, etc.
Please make sure it reflects your area of expertise as related to your presentation. For example, don't use "Writer" and leave it at that (unless you're presenting about writing).
This will be promoted on the Meet The Speakers page next to your bio (and elsewhere)
Which of these statements describes you best?
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It's important to me that all speakers are neurodivergent in some way or other, so this question is just to make sure that that happens ๐
(Also, "neurodivergent" doesn't just mean ADHD or Autistic)
Which of these statements describes you best?
๐ฃ IMPORTANT NOTE ABOUT SELF-DIAGNOSIS:
Here's my thoughts on self-diagnosis: I'm super for it, as long as it's not like "I'm so ADHD lol", you know what I mean?
If you've done your research, if you've really really thought about it, and you're 75-80% sure you have ADHD, or anxiety, or whatever neurotype, I think you have every right to identify as that without an official diagnosis.
That was me for the first year and a half of me calling myself ADHD because I had a stupid doctor who refused to diagnose me because my coping skills/masking was too strong. Some people don't have access to getting a diagnosis, sometimes it's prohibitively expensive to get assessed, sometimes it might be dangerous in your family to get diagnosed (just look at Britney Spears!).
All that said, if you're hesitant to openly identify as a neurotype because you're worried it's unethical if you don't have an official diagnosis, I don't think it's unethical to self-diagnose as long as you do it with intention ๐
So anyway, with that in mind...
If you're comfortable with it, please tell me a little more about your brain and in what ways/why you identify as neurodivergent
This question is intentionally optional.
๐ My only goal here is to make sure that multiple neurodivergent identities and experiences are represented in the speaker lineup (for example, I don't want it to accidentally become the ADHD Entrepreneur Summit). Anything shared here will be kept private, unless you explicitly give consent otherwise.
If you're comfortable with it, I'd love to know what neurotypes you identify with.
Remember, "neurodivergent" means more than just ADHD or Autistic. Other neurotypes could include anxiety disorder, chronic depression, OCD, bipolar disorder, dyslexia, etc.
And if you're neurodivergent, but prefer not to divulge in what way specifically, that's totally okay if you prefer to keep that to yourself ๐ค
Please keep it under 100 words, with no line breaks. Check it in
wordcounter.net before submitting
Please upload a SQUARE headshot
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The headshot *must* be square. Minimum file size 600x600 px
So I can send you a little gift (make sure it's one where you can accept packages!)
Presentation Title/Topic
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Enter the title you plan to use for your presentation (or at least a working title)
You're welcome to change this when it comes time to submit your presentation material, but this will give us something to put on the Registration and Schedule pages in the meantime.
Sign the Speaker Agreement at this link
Schedule the quick coffee chat to discuss your presentation here
Are you interested in sponsorship information?
Are you interested in sponsorship information?
Are you interested in participating in a Live Speaker Panel?
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Are you interested in participating in a Live Speaker Panel?
Anyone that you think would make a perfect speaker for this event that I should invite next year?
If you have a podcast (or some other platform), would you like to have Claire on as a guest leading up to the summit as a way to promote your affiliate link?
If you have a podcast (or some other platform), would you like to have Claire on as a guest leading up to the summit as a way to promote your affiliate link?
Anything else you'd like me to know?