Speaker Application Form
The Guyana Relationship Summit
Presented by Manifesting the Relationship You Want
Hosted by Coach Michelle Cumberbatch
Thank you for your interest in speaking at The Guyana Relationship Summit. Please complete all required fields below. Applications are reviewed by our Programming Committee, and selected speakers will be contacted directly.
SECTION 1 — Personal Information
Full Name Required
Professional Title
Organization / Company
City
State / Province
Country
Email Address Required
Mobile Phone
Website
SECTION 2 — Professional Biography
Short Biography (150–250 words)
(This may be used on our website and promotional materials if selected.)
SECTION 3 — Areas of Expertise
Please select all that apply.
☐ Healthy Relationships
☐ Marriage Enrichment
☐ Dating & Courtship
☐ Communication
☐ Conflict Resolution
☐ Emotional Intelligence
☐ Parenting
☐ Family Leadership
☐ Men's Development
☐ Women's Development
☐ Faith & Relationships
☐ Mental Health & Wellness
☐ Financial Harmony
☐ Leadership
☐ Personal Growth
☐ Youth Development
☐ Self-Worth & Boundaries
☐ Trauma Recovery
☐ Other:
SECTION 4 — Presentation Information
Proposed Session Title
Session Description (250–500 words)
Three Learning Objectives
Participants will learn to:
Presentation Level
☐ Beginner
☐ Intermediate
☐ Advanced
Intended Audience
☐ Singles
☐ Dating Couples
☐ Engaged Couples
☐ Married Couples
☐ Parents
☐ Young Adults
☐ Church Leaders
☐ Counselors
☐ General Audience
☐ Other
Preferred Presentation Format
☐ Keynote Address
☐ Workshop
☐ Breakout Session
☐ Panel Discussion
☐ Fireside Conversation
☐ Interview
☐ Virtual Presentation
Preferred Presentation Length
☐ 30 Minutes
☐ 45 Minutes
☐ 60 Minutes
☐ 90 Minutes
SECTION 5 — Speaking Experience
Approximately how many professional presentations have you delivered?
☐ 1–10
☐ 11–25
☐ 26–50
☐ 50+
Have you previously spoken in Guyana?
☐ Yes
☐ No
Have you previously spoken internationally?
☐ Yes
☐ No
If yes, where?
SECTION 6 — Media Links
Please provide links to previous presentations.
Speaker Reel
YouTube
Podcast Interviews
TEDx / Conferences
Other Media
SECTION 7 — Supporting Documents
Please upload the following (where available):
☐ Professional Headshot
☐ Speaker One-Sheet
☐ Curriculum Vitae / Résumé
☐ Sample Presentation Slides
☐ Additional Supporting Materials
SECTION 8 — Social Media
YouTube
X (Twitter)
TikTok
SECTION 9 — Logistics
Are you available to attend in person?
☐ Yes
☐ No
Would you be willing to present virtually if necessary?
☐ Yes
☐ No
Do you require any special accommodations?
☐ Yes
☐ No
If yes, please explain.
SECTION 10 — Promotion
If selected, may we:
Use your biography?
☐ Yes ☐ No
Use your professional headshot?
☐ Yes ☐ No
Record your presentation?
☐ Yes ☐ No
Livestream your presentation?
☐ Yes ☐ No
Use excerpts from your presentation for future promotion?
☐ Yes ☐ No
SECTION 11 — Additional Information
Is there anything else you would like the Programming Committee to know?
SECTION 12 — Speaker Agreement
By submitting this application, I certify that:
☐ The information provided is accurate.
☐ I am the creator or authorized presenter of the proposed content.
☐ My presentation is educational and original.
☐ If selected, I agree to collaborate with the Programming Committee regarding scheduling and presentation requirements.
☐ I understand that submission of this application does not guarantee selection.
☐ I agree to abide by the policies and Code of Conduct of The Guyana Relationship Summit.
Electronic Signature
Full Name
Date
Submit Your Application
Thank you for your interest in speaking at The Guyana Relationship Summit.
Our Programming Committee carefully reviews every submission to create a diverse, engaging, and impactful program. Applicants will be notified of the committee's decision after the review process has been completed.