Speaker On-Boarding Form

We are so grateful for your willingness to work with us at S.A. Lifeline & SAL12Step.

Personal Information

Name(Required)

First Last

Email(Required)

Phone(Required)

Address(Required)

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

Do you have any food allergies?(Required)

Yes

What food allergies should we be aware of?(Required)

Headshot(Required)

Max. file size: 50 MB.

Personal/Business Bio(Required)

Social Media Links

Instagram

Facebook Page

YouTube Channel

Presentation Info

Official Title of Presentation(Required)

Brief Summary of Presentation(Required)

What is your availability on the day of the conference? Can you do an afternoon break-out session? If so, what topic would you like to speak on? Can you do a Q & A session at the conclusion of the conference?

Tech & materials requested for presentation

Travel Preferences

Where will you be traveling from?

What day, time would you prefer to arrive?

When would you prefer to depart?

Do you want to book your own flight, hotel or would you prefer us to do that?(Required)

I can book my own

I'd prefer you book them

Preferred airline. Sky miles number?

Transportation while at the conference:(Required)

Uber

Ride from a team member

I'll have my own transportation

If you would prefer we book your travel and hotel, we will ensure that you are on a non-stop flight to and from your destination and we will reserve a room for one or two nights. We can also schedule ubers, provide transport through one of our foundation members, or rent a car. If you would prefer to book these yourself, we will let you know our travel and accommodation budget and we are happy to reimburse you accordingly.

Who is S.A. Lifeline Foundation?

Our Audience
Our audience will be individuals and couples suffering from sexual addiction and betrayal trauma as well as therapists and ecclesiastical leaders who help in this field. These participants will have varying degrees of understanding and experience related to addiction and betrayal trauma recovery.

Personal Information

Social Media Links

Presentation Info

Travel Preferences

Who is S.A. Lifeline Foundation?

SAL12-Step Recovery Tools

Service Opportunities

Start & Run SAL Meetings

Buy Materials for 12-Step Work

Download the full version of the Serenity Prayer