Your Name (required)
Hypnosis Affiliations (required)
Address Including City, State and Zip code
Your Email (required)
Please Check the Track or Tracks You Are Applying to Present a Program
Check to apply to present a Program in the Clinical Hypnosis TrackCheck to apply to present a Program in the Stage Hypnosis TrackCheck to apply to present a Program in the The Business of Hypnosis TrackCheck to apply to present a Program in the The Metaphysical Hypnosis Track (Spiritual or Religious uses of Hypnotism)
PLEASE NOTE: You need to provide a list of the behavioral objectives the participants are expected to achieve for each of the tracks above. Please click here to view “How to Write Behavioral Objectives”.
Please Check the Desired Duration of Your Speaking
1 Hour2 HoursOther: Specify in comments
Degrees, Title, Professional Certifications, etc (required)
Will your proposal be interactive and how?(required)
Proposed Program Title and Format (required)
Proposed Program Description in 100 words or less (Please submit as you would like it to appear in the program and event promotion. William Mitchell Events reserves the right to edit the description submitted for brevity or greater clarity). (required)
Please list your Behavioral Learning Objectives and any relevant sources for your presentation (required)
Biographical Information in 100 words or less. (Information submitted will be subject to editing as necessary). (required)
Any Special Message or Comments
*Everyone submitting a proposal to speak at the conference MUST submit a video promoting your presentation. You can send to email@example.com or through Google Drive, Dropbox or any of the other cloud services. You must also submit the video to youtube or vimeo and send us the URL. This is a REQUIRED element for 2019. No proposals will be reviewed without the video. If you have any questions please feel free to contact us (firstname.lastname@example.org, email@example.com) for direction on how to do it. This is a new and exciting element we are adding to the Speaker approval process.
By submitting this proposal, you are agreeing to promote the Heartland Hypnosis Conference and your participation in the conference to your community members and followers on social media platforms you participate on and to any email lists you maintain related to your hypnosis practice. In addition, you agree to participate in any webinars or interview sessions William Mitchell Events might schedule leading up to the event and possible follow-up sessions after the event has concluded. You also agree to allow usage of your video you submitted as part of this proposal to be used for promotion of the Heartland Hypnosis conference and your presentation.
In consideration of your participation in the Heartland Hypnosis Conference, you will qualify for a discounted conference registration fee of only $175 to present at the conference If your proposal has been submitted and approved before November 1, 2017. Presenter registration fees will increase to $200 for accepted proposals processed between November 1, 2016 and January 1, 2017. The discounted conference fee includes your participation in all seminars and lunch for all 3 days.
We look forward to receiving and reviewing your proposal.
Presenters with selected Proposals must agree to the following stipulations:
• Provide a recent photo(s) website, social media profile links and biographical data
• Provide a short video (from a phone is fine) promoting your presentation
• Send at least 2 emails to your list promoting the Heartland Hypnosis Conferences and your presentation
• Participate in a webinar or webinars featuring presenters.
• Collaborate with other presenters and William Mitchell Events in actively promoting the Heartland Hypnosis conferences.
• Refrain from making any substantial changes in program content or format without prior approval from William Mitchell Events.
• Allow William Mitchell Events to audio and/or video record the presentation for educational purposes and future use.
• Refrain from using the session time as an infomercial. (You may use the last 5 minutes of your presentation time to mention and promote your products or services and supply brochures.)
• Submit registration fees for the conference to secure your presentation position for the conference.
By submitting this proposal form electronically, you agree to the above stipulations.
To attract more Heartland Hypnosis Conference attendees and to get speakers to do social media posts about the class they will present at
All approvals are provisional until the presenter registers and pays the registration fee and submits a 400 word Blog about their topic.
Not a sales pitch to attend your class. Rather we want content about your topic. Information in your Blog that will inform people about your topic.
These will be used on both speakers and Heartland's social media and the Heartland website.
If you have not responded by Dec.1 st your proposal has been rejected.
William Mitchell, M. Div., BCH, CI
William Mitchell Events
Mitchell Institute of Professional Hypnosis
Personal Motivation Hypnosis Clinics
Please submit below or return this completed form by mail or email to HypnosisClinic@sbcglobal.net
2700 W. Lawrence Ave, Suite N
Springfield, IL 62704