Candidate Speakers Application

Thank you for your interest in participating in NSAHouston as a Candidate Member. Please complete the following application to help us determine both your readiness for this program and how we can best support your goals in further developing your professional speaking career. Following completion of the application please send an email to Membership Director Karen McCullough at karen@karenmccullough.com to let her know you have applied. May this be the start of a long lasting relationship of mutual support, education and business development.

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* 1. Your contact information:

Name

Company

Address 1

Address 2

City

State

Zip

Email Address

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* 2. Phone:

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* 3. Email:

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* 4. Web Page:

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* 5. LinkedIn:

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* 6. Twitter:

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* 7. How did you hear about NSAHouston?

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* 8. Where and When have you completed either National's or a Chapter's Speaker Academy?

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* 9. How would you describe your current career as a speaker, trainer, and/or coach?

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* 10. Where do you like your speaking career to be in 12 months?

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* 11. Where would you like your speaking career to be in five years?

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* 12. Please describe what you want to accomplish, both personally and professionally, through your experience with the NSAHouston that would support your speaking career goals:

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* 13. Have you been a member of Toastmasters?

Yes

Please comment on the extent of your experience with Toastmasters

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* 14. How many total speaking engagements have you had in the last year?

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* 15. How many paid speaking engagements have you had in the last year?

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* 16. Do you currently have marketing materials describing yourself as a speaker, e.g., a one sheet?

Yes

If Yes, at what URL can it be viewed online?

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* 17. [Do you currently have audio and/or video as a speaker?

Yes

If Yes, at what URL(s) can it be accessed online?

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* 18. [Do you currently have a YouTube channel?

Yes

If Yes, at what URL(s) can it be accessed online?

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* 19. Do you currently have a blog?

Yes

If Yes, at what URL can it be viewed online?

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* 20. Do you currently have a book published (self or otherwise)?

Yes

If Yes, at what URL can it be viewed online?

Thank you. Please hit "Submit" below to have your responses saved. Also, please send an email to Karen McCullough at karen@karenmccullough.com to let us know you applied. SurveyMonkey sends us no notifications. Thanks.