Moxie Camp
Speaker Application
Thank you for your interest in presenting at Moxie Camp, a FREE, weeklong, experiential virtual event for coaches. Held during International Coaching Week (May 3- 9, 2021), Moxie Camp is designed for coaches who want to amplify their voices, visibility, and influence so they can show their clients and employees how to do the same.
During this unique virtual event, produced and hosted by Alexia Vernon (author of Step into Your Moxie and creator of the Step into Your Moxie® coaching and empowerment platform), approximately a dozen coaches will lead LIVE, interactive, Zoom workshops for fellow coaches in the following 5 areas: Unlock Your Authentic Voice as a Coach, Grow Your Coaching Platform, Garner Visibility and Media Attention, Integrate Social Justice and Center Marginalized Voices, and Up Level from Coach to Trusted Thought Leader.
If you would like to be considered to present an interactive, virtual workshop for an anticipated audience of 1000+ registered event attendees, please fill out and submit your Speaker Application on or before March 8, 2021. (The Step into Your Moxie® platform believes in the importance of illuminating and centering marginalized voices. Coaches who are BIPOC, LGBTQIA, non-native English speakers, living with disabilities and chronic illnesses, and are members of other marginalized communities are particularly encouraged to apply.)
Speaking invitations will be extended on a rolling basis, so please apply early. All applicants will be notified about the status of their applications on or before April 2, 2021.
Note: Once you submit your Application you won’t be able to edit your answers. Please create your responses in a separate document prior to entering them into your Application.
Thank you for your interest in presenting at Moxie Camp, a FREE, weeklong, experiential virtual event for coaches. Held during International Coaching Week (May 3- 9, 2021), Moxie Camp is designed for coaches who want to amplify their voices, visibility, and influence so they can show their clients and employees how to do the same.
During this unique virtual event, produced and hosted by Alexia Vernon (author of Step into Your Moxie and creator of the Step into Your Moxie® coaching and empowerment platform), approximately a dozen coaches will lead LIVE, interactive, Zoom workshops for fellow coaches in the following 5 areas: Unlock Your Authentic Voice as a Coach, Grow Your Coaching Platform, Garner Visibility and Media Attention, Integrate Social Justice and Center Marginalized Voices, and Up Level from Coach to Trusted Thought Leader.
If you would like to be considered to present an interactive, virtual workshop for an anticipated audience of 1000+ registered event attendees, please fill out and submit your Speaker Application on or before March 8, 2021. (The Step into Your Moxie® platform believes in the importance of illuminating and centering marginalized voices. Coaches who are BIPOC, LGBTQIA, non-native English speakers, living with disabilities and chronic illnesses, and are members of other marginalized communities are particularly encouraged to apply.)
Speaking invitations will be extended on a rolling basis, so please apply early. All applicants will be notified about the status of their applications on or before April 2, 2021.
Note: Once you submit your Application you won’t be able to edit your answers. Please create your responses in a separate document prior to entering them into your Application.
Name*
First
Last
Email*
Title*Company*Cell Phone Number*Mailing address*
Street Address
City
State / Province / Region
ZIP / Postal Code
Country
AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands
Assistant’s Name (if applicable)
First
Last
Assistant’s Email Address (if applicable)
How would you describe your area(s) of coaching expertise?*How many years have you been a coach?*In 50-words or less, please describe your coaching education, credentials, and noteworthy awards or accomplishments?*In 50-words or less, please describe why you’d like to speak at Moxie Camp and why you’d make a great speaker.*Proposed Workshop Title*Which of the following 5-areas does your workshop fit under? (Please only choose 1.)*Unlock Your Authentic Voice as a CoachGrow Your Coaching PlatformGarner Visibility and Media AttentionIntegrate Social Justice and Center Marginalized VoicesUp Level from Coach to Trusted Thought LeaderIn 150 words or less, please describe your proposed interactive workshop as clearly as possible for a potential participant. (Note: You should have 45-minutes of interactive workshop content that does NOT include participant Q&A.)*Please list 5 relevant questions Alexia could ask you during the 15-minutes of Q&A following your proposed 45-minute workshop.*Please finish the following statement in 3-4 bullet points. “By the end of my workshop, session participants will be able to…” (Example: Create compelling copy for a speaker one-sheet)*In 150 words or less, please provide your Speaker Bio.*Please provide a link to a high-resolution photograph that will be used in event publicity if you are chosen as a speaker*If possible, please provide a link showing you present online or in-person.
Please provide the link to your free, online offer if you will be offering one at the end of your virtual workshop (Note: This offer should be something that is available the 1st week of May when the virtual event is held.) You may leave this blank if you are not providing an offer.If you are selected as a Moxie Camp Speaker, you will be asked to email your full newsletter list a minimum of 1 time and post a minimum of 2 times on the social networks you use. Recommended swipe copy and images will be provided for your promotional convenience.How many people are on your full newsletter list?*What day between April 19 – May 1, 2021 will you email your full newsletter list if chosen as a speaker?*If you are sending a reminder email to your full newsletter list between April 19 – May 1, 2021, what day will that be?What other social media networks are you on (i.e., Facebook, Twitter, Instagram, LinkedIn, and Clubhouse), AND what 2 days between April 19 – May 1, 2021 will you commit to promoting Moxie Camp if chosen to speak?*Moxie Camp Speaker AgreementConsent* By entering my name and the date below, I acknowledge that I have read and agree to the Terms & Conditions outlined in the Moxie Camp Speaker Agreement, and I consent to joining the Alexia Vernon Empowerment, LLC virtual community and receiving periodic updates via email.Full Legal Name*
First
Middle
Last
Date*
Date Format: MM slash DD slash YYYY
CAPTCHANameThis field is for validation purposes and should be left unchanged.
jQuery(document).ready(function($){gformInitSpinner( 19, ‘https://alexiavernon.com/wp-content/plugins/gravityforms/images/spinner.gif’ );jQuery(‘#gform_ajax_frame_19’).on(‘load’,function(){var contents = jQuery(this).contents().find(‘*’).html();var is_postback = contents.indexOf(‘GF_AJAX_POSTBACK’) >= 0;if(!is_postback){return;}var form_content = jQuery(this).contents().find(‘#gform_wrapper_19’);var is_confirmation = jQuery(this).contents().find(‘#gform_confirmation_wrapper_19’).length > 0;var is_redirect = contents.indexOf(‘gformRedirect(){‘) >= 0;var is_form = form_content.length > 0 && ! is_redirect && ! is_confirmation;var mt = parseInt(jQuery(‘html’).css(‘margin-top’), 10) + parseInt(jQuery(‘body’).css(‘margin-top’), 10) + 100;if(is_form){jQuery(‘#gform_wrapper_19’).html(form_content.html());if(form_content.hasClass(‘gform_validation_error’)){jQuery(‘#gform_wrapper_19’).addClass(‘gform_validation_error’);} else {jQuery(‘#gform_wrapper_19’).removeClass(‘gform_validation_error’);}setTimeout( function() { /* delay the scroll by 50 milliseconds to fix a bug in chrome */ jQuery(document).scrollTop(jQuery(‘#gform_wrapper_19’).offset().top – mt); }, 50 );if(window[‘gformInitDatepicker’]) {gformInitDatepicker();}if(window[‘gformInitPriceFields’]) {gformInitPriceFields();}var current_page = jQuery(‘#gform_source_page_number_19’).val();gformInitSpinner( 19, ‘https://alexiavernon.com/wp-content/plugins/gravityforms/images/spinner.gif’ );jQuery(document).trigger(‘gform_page_loaded’, [19, current_page]);window[‘gf_submitting_19’] = false;}else if(!is_redirect){var confirmation_content = jQuery(this).contents().find(‘.GF_AJAX_POSTBACK’).html();if(!confirmation_content){confirmation_content = contents;}setTimeout(function(){jQuery(‘#gform_wrapper_19’).replaceWith(confirmation_content);jQuery(document).scrollTop(jQuery(‘#gf_19’).offset().top – mt);jQuery(document).trigger(‘gform_confirmation_loaded’, [19]);window[‘gf_submitting_19’] = false;}, 50);}else{jQuery(‘#gform_19’).append(contents);if(window[‘gformRedirect’]) {gformRedirect();}}jQuery(document).trigger(‘gform_post_render’, [19, current_page]);} );} ); jQuery(document).bind(‘gform_post_render’, function(event, formId, currentPage){if(formId == 19) {} } );jQuery(document).bind(‘gform_post_conditional_logic’, function(event, formId, fields, isInit){} ); jQuery(document).ready(function(){jQuery(document).trigger(‘gform_post_render’, [19, 1]) } );