Join Us - Professional — Professional Speaking Association

Your name*

Title First name Last name

Company / organisation name

Address*

Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country

Telephone

Mobile Telephone*

Email*

Website*

Why do you want to make this application?*

List your 10 most recent speaking events*

Please list your TEN most recent speaking events for audiences of 3 or more people. (Click the + sign to add a new row.)

Date

Event

Audience size

I earn money from speaking*

Yes

No

Your paid speaking events*

Please list THREE paid speaking engagements you have conducted in the last 12 months. (Click the + sign to add a new row.)

Date

Event

Amount invoiced

Link to video of you speaking*

Please provide a link to a video of you speaking, either on YouTube or another online video service or your own website. This must be to a live audience.

You require TWO proposers who can be either Professional Members or Fellows but can not be current board members. Associate Members cannot propose you for this grade of membership. Your first proposer (and ideally your second) must have seen you speaking in person.

First proposer's name*

The name of your first proposer. This person must have seen you speaking live.

First Last

Second proposer's name*

The name of your second proposer.

First Last

Has your second proposer seen you speaking live?*

Yes

No – but they have viewed the video provided on this form

Why have you chosen your second proposer as a video viewer rather than someone who has witnessed you speak in person?*

Date you were seen speaking by a proposer*

Please enter the date on which one of your proposers saw you speak. You must have been seen speaking within the last 12 months.

Proposers agreement*

I confirm the proposers above have agreed to support my application

How did you hear about the PSA?*

Referrer's name

Have you been introduced to the Association by another member? If so please provide their name below so we can thank them. (One name only please).

First name Last name

Ethics*

I confirm I agree with the ethical principles of the PSA

You are required to agree to the ethical code of conduct of the PSA. (Link opens in new tab)

Age confirmation*

I confirm I am 18 years old or older

If you are under 18 and interested in membership, please contact us to discuss. (Link opens in new tab)

Annual Subscription - Professional Member

This is a recurring annual card payment for Professional Membership of the PSA. Your card will be charged £275.00 now and again on each anniversary of your membership.

Payment card*

Important information about membership upgrades

Completing this form will result in your card being charged for the full £225 Professional Membership fee now. Your annual renewal date will also change to today's date.
We will review your membership status when processing your application. A pro-rata refund will be issued for any unused time on your previous membership grade if applicable.

I do not wish to receive information from the PSA after my membership has come to an end.

When I submit this form, I understand that the PSA will process my information in accordance with its Privacy Notice.

Comments

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Application - Professional Member - Credit Card