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NSA/GLAC Speakers Academy Application
Street address
Office Phone number
Home number
E-mail address
Current Occupation

  1. My interest in the NSA/GLAC Speakers Academy is:
       I would like to apply to the Academy.
    I have read and understand the Speakers Academy program information.
       I would like to apply to the Academy.
    I am interested in the Academy, but need to consider the following items/issues before making a final decision:

    I am interested in the Academy, but the timing doesn’t work for me now. Please contact me when the next program is scheduled.

  2. What are your areas of speaking expertise?

  3. Prior professional (paid) speaking experience

    Which of the following best describes your current situation?

       Full time speaker for year(s)

       Part-time speaker for year(s)

       Occasional speaker for year(s)

       Have never spoken as a paid professional speaker
        Please briefly describe your professional (paid) speaking experience:

  4. Other (unpaid) speaking experience

    Please check all that apply

       Am a member of toastmasters for year(s)

       Am a member of Speaking Circles for year(s)

       Attended other presentation skills programs

         Please describe:

    Attended other presentation skills programs
    How often in the last two years?
        Please briefly describe your unpaid speaking experience:

  5. What is your goal regarding your speaking career?
       Full time paid professional speaker

       Part-time paid professional speaker

       Occasional paid professional speaker
        Other Speaking career goals

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

    Please check all that apply





       Don't Know

  7. On what topics do you currently or intend to present?

  8. Please describe any books you have published that relate to your intended speaking topic.

  9. Which of the following do you currently have or produce?

    Please check all that apply

       Articles (magazine, newspaper, etc)
       Demo video
       One-sheet (promotional piece)

  10. Subject to unforeseen circumstances, I commit to the following:

    Please check all that apply

       Attend all classes
       Complete homework timely
       Pursue NSA membership

  11. What would you like to accomplish during and as a result of completing the Speakers Academy?

  12. Do you have any additional needs or requirements that you would like to bring to our attention?

  13. How did you hear about the Speakers Academy?

No refunds will be issued after April 8, 2017.

The NSA/GLAC does not discriminate on the basis of age, creed, disability, gender, national origin, race, or sexual orientation.


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