Sign Up for Public Speaking Training Please enable JavaScript in your browser to complete this form.First Name *Last Name *Date of Birth (dd/mm/yyyy)Email *EmailConfirm EmailPhone number (area code / mobile prefix then number) *OccupationNote: This helps me understand how I can tailor the content to your needs and the type of speaking done in your work role. How did you hear about us?Referral from a friend (word of mouth)Internet searchFacebookNewspaperOtherCommentsWould you like a free 10-minute phone chat?YesNoThis chat can help us to discuss your challenges and goals with respect to public speaking, and whether you’re best suited to a six-week program or one or two private consultations first.What day of the week (evening) / or Saturday do you prefer for consultations (we will contact you to confirm availability)If enrolling, which program are you enrolling in‘Speaking toolkit’ six-week course‘Pitch perfect’ Private coaching What method of coaching do you prefer?OnlineIn PersonWhere are you located? (Town/City) *This helps me understand the best way to deliver coaching for you.What are your ambitions/goals for public speaking?What do you MOST want to improve in relation to your public speaking?Are you OK with your image being used in The Speaking Coach’s marketing material?YesNoDo you have any learning difficulties we need to be made aware of? If yes, please give some detailsWould you like to sign up for our e-newsletter of public speaking tips, tricks, news, and articles from the Speaking Coach?Note: We do not provide your emails to third parties and do not bombard you with advertising. From time to time we will send out a client e-newsletter with commentary on topics of interest regarding public speaking.Terms and Conditions *I agree to the terms of service.You can view a copy of our terms here. (opens in a new window)Submit