Application

Fill out the below form to start the application process for the 2018 NSA Northern California Speakers Academy.

For more information, please contact Academy Dean Tony Woodall at (415) 857-0225 or info@nsanc.org.

Important: If you have not been contacted within 48 hours after submitting your application, please contact Tony directly.

Contact Information

Name (required)
First Last

Degree/Professional Designation

Mailing Address (required)

Street
City, State, ZIP

Company

Phone 1 (required)
Phone 2
Phone 3
Phone 4

Email (required)

Website

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 understand that the program costs $1,995. I have read and I understand the Speakers Academy Program information. I agree that, once accepted and a deposit has been made, 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, Kiwanis, Lions, 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
Demo video
One-sheet
Other:

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

Attend all nine monthly meetings of Speakers Academy
Do all homework assignments
Attend all five NSA/NC 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.

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