Speakers Academy Registration

Name*

First Last

Email*

Address*

Street Address City State ZIP Code

Mobile Phone*

What is your area of speaking expertise?*

Are you currently a member of NSA or NSA St. Louis?*

What is your past speaking experience?*

Please check all that apply.

How many times have you spoken to a group for 40 minutes or more in the past two years?*

What types of programs do you intend to present?*

Please check all that apply.

I commit to ALL of the following, barring any unforeseen events:*

Select All
Attend all of the semi-monthly meetings of the NSA STL Speakers Academy
Do all homework assignments
Attend all three of the monthly meetings of NSA STL while enrolled in the academy
Apply for national membership in the NSA and in NSA STL when I meet the qualifications

Do you have any disability needs requiring special consideration?*

**If Yes, please describe

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

Did someone refer you to Speakers Academy? If so, who?*