SPEAKER APPLICATION FORM
Full Name
*
Phone
*
Email
*
Business Name
*
How long in business?
Have you spoken before? (Yes/No)
Yes
No
What is your speaking topic?
Why should we have you speak?
What is your business 12-month income?
250k or less
250-750k
750k-1.5 million
1.5 million+
Would you promote it?
If we had you speak at the event, would you promote it?
Yes
No
Voice AI Outbound Calling & Messaging Consent (BrandX Agency) By submitting your contact information through BrandX Agency or its affiliated platforms, you expressly consent and agree to receive marketing, informational, and transactional communications, including telephone calls and SMS/text messages, from BrandX Agency, its representatives, affiliates, and authorized partners, at the phone number(s) you provide. You acknowledge and agree that: Calls and messages may be delivered using automated systems, including pre-recorded messages, artificial intelligence (AI) voice technology, and Voice AI outbound calling tools, where permitted by law. Communications may be made for purposes including, but not limited to, lead follow-up, qualification, appointment setting, marketing offers, product or service information, and business development. Your consent applies even if your phone number is listed on any federal or state Do-Not-Call registry. Consent is not a condition of purchase. Opt-Out & Revocation of Consent You may revoke your consent or opt out of future communications at any time by: Replying “STOP” to any text message, Requesting removal during a phone call, or Contacting BrandX Agency directly using the contact information provided on our website. Upon opting out, you will no longer receive outbound communications except as required by law. You confirm that you are the authorized user of the contact information provided and that you are at least 18 years of age.
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