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| I'd like to find out more about the following courses and workshops |
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Private
Accent Reduction, Voice, or Speech Coaching |
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Group Accent Reduction, Voice, or Speech Workshops |
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Private Executive Public Speaking Coaching |
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The Confident Speaker - Public Speaking Workshops for Groups |
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Our New Improv Workshops! |
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1. What kind of public speaking does your job demand? (Check any box that applies) |
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a. None |
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b. One-On-One |
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c. Casual meetings with a group of less than 10 people |
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d. Formal meeting with a group of less than 10 people |
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e. Casual conference speeches for groups of more than 10 people |
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f. Formal conference speeches for groups of more than 10 people |
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g. Television Interviews |
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h. Impromptu speaking at special events |
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i. M.C. duties at special events |
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j. Briefings (Planned oration) |
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k. Sales Pitches |
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l. Other |
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| 2. How often do you give a speech of 3 minutes or longer to a group of more than 5? |
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a. Never
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b. Daily |
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c. Weekly |
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d. Monthly |
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e. Quarterly |
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f. Other |
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3. Do you get K? (Check all that apply)
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a. Months before the presentation |
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b. A night before the presentation |
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c. A few hours before the presentation |
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d. During the presentation |
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e. After finishing the presentation |
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4. Symptoms of my anxiety include: (Check all that apply) |
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a. Sweating |
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b. Loss of vocal power |
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c. Difficulty forming thoughts or words |
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d. Hysteria |
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e. Paranoia |
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f. Blurred vision |
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g. Nausea |
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h. Pale complexion |
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i. Dry mouth |
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j. Fast speech |
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k. Excessive blinking |
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l. Excessive gestures |
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m. Other |
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| 5. Do you make excuses or plan time conflicts in order to avoid speaking |
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a. Never |
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b. Rarely |
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c. Sometimes |
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d. Often |
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e. Always |
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6. Check all areas you feel you need to improve on.
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Breath support and connection |
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Vocal Quality |
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Projection |
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Articulation |
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Pitch Inflection |
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Accent |
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Anxiety |
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Presence |
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Posture |
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Gestures |
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Facial Expression |
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Eye Contact |
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Speech Composition |
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Cross-Cultural Communication |
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Connection To Material |
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Connection To Audience |
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Word Choice |
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Telephone Skills |
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| When and how would you like to be contacted to discuss
your communication needs? |
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| What prompted you to look for communication coaching? |
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| How did you hear about Speak by Design? Were you
referred? |
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| If you are seeking private coaching, what are you
looking to achieve? |
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| When would you like these services performed? |
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we could provide? |
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