Membership Luncheon Speaker Form | Winnipeg Chamber of Commerce

Presenter Details

Name*

First Last

Phonetic Spelling of Name

What are your pronouns? Please choose all that applies to you.

Company*

Job Title*

Email*

Phone*

Shipping Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Dietary Restrictions

Please list any dietary restrictions you have. *Please note, this section only applies to those doing in-person presentations.*

Company Website*

Company Twitter

Company Instagram

Personal LinkedIn

Personal Twitter

Personal Instagram

Marketing the Event

The following information will be used to promote your event:

Bio

3 to 5 key points attendees will learn*

Please upload your headshot

Accepted file types: jpg, png, Max. file size: 20 MB.

Please upload any photos or videos you think would be valuable to share with our members in promoting your luncheon

Drop files here or

Accepted file types: mp4, mov, jpg, png, Max. file size: 20 MB.

Please link any resources you think would be valuable to share with our members in promoting your luncheon

Self Declaration

The collection of self-identification data questions below are a part of The Chamber’s commitment to diversity, equity, and inclusion (DEI). It will help The Chamber best serve you and our business community. This data will allow us to analyze the diversity within our event speakers and programs, monitor our DEI efforts, and recognize and remove barriers to ensure inclusive and accessible events. This self identification section is voluntary.

Are you an Indigenous person? (First Nations, Inuit, or Métis)

Which of the following best describes your racial identity? Please check all that apply:

If you chose "Prefer to self describe" to above question, please respond here:

Do you identify as a member of the 2SLGBTQ+ community?

The 2SLGBTQ+ acronym is used for people who may identify with one, or many of the following: Two‐Spirit, Lesbian, Gay, Bisexual, Transgender, Queer, Questioning, Inter‐sex, Asexual, + denotes anyone who does not identify as any of the above, or heterosexual and/or cisgender.

What is your gender identity?

If you chose "Prefer to self describe" to above question, please respond here:

Are you a Person with a Disability?

We strive to host inclusive, accessible events that enable all individuals to engage fully. If you require accommodation please let us know here:

If you chose "Yes" to above question, please respond here with required accommodations:

Consent*

I agree to the privacy policy.

Information collected in our Speaker form is for the sole purposes outlined above and is only accessible by designated staff on a need-to-know basis. We strive to protect your information, following the guidelines set out in our Privacy Policy. We do not share your information with any third parties.

Membership Luncheon – Speaker Form

Presenter Details

Marketing the Event

Self Declaration

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