General Information |
| Name: | |
| Address: | |
| City, State, Zip Code: | |
| Home Phone: | |
| Business Phone: | |
| Mobile Phone: | |
| Email Address: | |
| Web Site: | |
Education |
| Educational Background (Click on highest completed.) |
| | High School
Community College |
| College: |
One Year
Two Years
Three Years
Completed
|
| Degree: | |
| Major area of concentration: | |
| Graduate School: | One Year
Two Years
More Than Two Years
Completed
|
| Degree(s): | |
| Major area of concentration: | |
History |
| Started speaking in what year? | |
| Started getting paid for speaking in what year? | |
| Are you a member of the Toastmasters International? |
Yes
No
|
| If yes, in what year did you join? | |
| Are you a member of the National Speakers Association? |
Yes
No
|
| If yes, in what year did you join? | |
| Brief description of your speaking history: |
|
| Range of highest fees earned for keynote: |
$500-$999
$1000-$1499
$1500-1999
$2000-3499
$3500-$4999
$5000 or more
|
| Topics for which you earned the above fees (may be multiple): |
|
| Range of fees earned for training, per day: |
$1000-$1499
$1500-1999
$2000-3499
$3500-$4999
$5000 or more
|
| Topics for which you earned the above fees (may be multiple): |
|
Knowledge |
| Areas of expertise in which you feel qualified to make a paid presentation: |
|
| During the last year please list, by percentage, your income from your presentation topics (e.g., 50% Leadership, 25% Relationship Management, 25% Change Management): |
|
Technical Skills |
| Do you have a laptop that has PowerPoint? |
Yes
No
|
| Version of PowerPoint: |
PC
Mac |
| Are you comfortable with PowerPoint? |
Yes
No
|
| Do you use PowerPoint in your current presentations? |
Yes
No
|
Expectations |
Why are you interested in D ATING Your Customer? |
|
| What do you hope to gain from this relationship? |
|
| How many keynotes, etc. would you like to present per year? |
|
Next Steps
If accepted you will be asked for Three references who can attest to your level of speaking. These references are for presentation and topic knowledge referrals only. Please do not supply them until we complete your preliminary evaluation.
This process is for speakers that are committed to earning a MAJOR portion of their income from professional speaking. We will partner with you to reach these goals. As a licensee we want you to succeed. However, success always requires hard work and a commitment to excellence. If you have questions about the program please contact us. One of our faculty members will respond to your inquiry.
Costs
Costs will be sent to you with your preliminary approval. Additional information will include payment plans, etc.
Our business model will show you a significant return on your investment. We anticipate that most approved applicants, upon completion of our seminar, will be able to recover 100% of all expenses in less than one year. Much depends on your speaking fee and frequency of presentations. However we do not request any funds or deposits until 100% of your questions or concerns have been addressed. Our business is built on referrals. It is important to us that you have a full and accurate understanding of our relationship. |
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