Speakers Academy Application

Contact Information

*First Name:

*Last Name:

Mailing Address (required)
*Street:

*City, State, ZIP:

*Company:

*Phone:

*Email:

Website:

Degree/Professional Designation:

Current Occupation:

1. My interest in the Speakers Academy program is:

I want to apply

I am VERY enthused and would like to apply to the program. I have read and I understand the Speakers Academy Program information.
I agree that, once accepted, the program tuition is non-refundable.

I’m considering it

I am enthused about the program, and I need to consider the following items before making my final decision:

2. What are your areas of speaking expertise?


3. Are you a member of NSA?

I’m a current member of NSA

I’m a salaried employee

How many times per year do you speak to groups of 15 or more?


I’m not a salaried employee

How many times per year are you paid to speak?

4. Are you speaking professionally?

Full-time – # years

Part-time – # years

Occasionally – # years

Have never presented
Comments

5. What is your past speaking experience?

Member of Toastmasters, Speaking Circles, etc.

Attended other presentation skills programs:

Spoken at Rotary, Lions, Soroptimist, other organizations (describe)


How many times in the last two years?:

6. What types of speaking programs do you intend to present?

Keynote

Seminars

Training

I don’t know yet

Other:


7. On which topics do you speak?


8. Please share details from any book(s) published


9. Which of the following do you have or produce? (check all applicable boxes)

Articles published on a regular basis

Newsletter

Demo video

One-sheet

Other:


10. I can commit to the following, barring unforeseen events:

Attend all monthly meetings of Speakers Academy

Do all homework assignments

Attend all five NSA/LV general membership meetings

Apply for membership of NSA when I meet the qualifications

11. Do you have any disability needs requiring special consideration?


12. Is there anything else you would like to share about yourself?


Please double-check all of your information above. Once you submit your application successfully, this form will be cleared. You will be emailed a copy of the accepted information.