First Name
Email
Phone
Current Role / Title
City / State / Country
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Which program are you most interested in exploring?
(Select one)
How did you hear about Industry Speaks Academy?
Social Media
Website
Email
Referral
We appreciate all referrals to the Academy, who can we thank for the kindness of your referral? (Name and company please)
Which statement best reflects your current season?
I am actively speaking and want to elevate my credibility and access
I have spoken before and want to re-enter with structure and momentum
I want to become a speaker and know I need practice and feedback
I am exploring whether speaking should be a focus now or later
Approximately how many professional speaking engagements have you completed?
0 – 3
4 – 10
11 – 25
25+
What best describes the largest audience you have spoken to?
Fewer than 50
50 – 250
250 – 1000
1000 – 2500
2500 – 7500
10,000+
Have you ever been paid to speak?
Yes
No
Are you willing to travel for speaking opportunities if selected?
Yes, domestically
Yes, domestically and internationally
Yes, with reasonable notice
No, I prefer local or virtual opportunities
Please identify speaking formats are you most interested in. (Select all that apply)
What are you preferred topics for speaking engagements? What topics are you now?
Which statement best reflects your current
My message is clear, but my delivery needs refinement
My delivery is solid, but my message needs focus
I feel scattered and unsure what I should own
I am still discovering my voice
What unique point of view or perspective do you feel you bring that you don’t hear enough of on industry stages?
How do you typically respond to direct, specific feedback?
I welcome it and apply it quickly
I welcome it but need time to process
I find it uncomfortable but necessary
I prefer encouragement over critique
When was the last time someone gave you honest feedback on your speaking that helped you improve?
Within the last 6 months
6-8 months ago
Over 2 years ago
Never (most common experience)
Describe the feedback that you received.
Which statement best reflects your availability for practice and preparation?
Monthly commitment is realistic
Weekly commitment is realistic
Self-paced only right now
Unsure
Please review and acknowledge the following statements to continue:
I understand that The Industry Speaks Academy does not guarantee speaking engagements
I understand that credibility and readiness are earned, not promised
I am open to being advised to start with foundational work if needed
I respect that not everyone is accepted or invited into advanced programs immediately
Is there anything else we should know about you, your experience, or your goals as a speaker?
I understand this is an application, not a guarantee of acceptance.
