LEAP ACADEMY 2017
MEMBERSHIP APPLICATION

THANK YOU FOR YOUR INTEREST IN THE LEAP ACADEMY

AS OF OCT. 28, 2017 AT 11:59PM
WE ARE NO LONGER ACCEPTING APPLICATIONS, BUT PLAN TO AGAIN SOON
Apply now
 
Thanks for your interest in joining the LEAP Academy

Please share your first name *

 
Please share your last name *

 
Please share your telephone number *

 
LEAP stands for 'Lived Experience And Paid'

Please share a bit about your mental health lived experience, what you're hoping to get out of this training and why you'd like to do more public speaking *

Please list you're mental health experiences, and your intentions with this training (Max 800 characters)
 
Please share some details about your current speaking experience and where you intend to take it over the next 2-5 years *

 
How would you rate your public speaking experience? *

1 = Never shared my mental health story on stage or with anyone outside close friends and family

10 = Spoken on large stages of 10,000+ and made $5,000+ per speech










 
Who (if anyone) let you know about this LEAP Academy Training?

 
Are you planning to apply for a LEAP Academy Scholarship? *

*LOW INCOME ONLY

We have a limited amount of scholarship funding to supplement part of your membership fees, but it is set aside for those who are low income and we may ask for financial statements

A separate LEAP Scholarship appication will be emailed to you if you click 'Yes' below
     
 
How are you wanting to pay for the training? *

LEAP Academy fee is: $400
Or 3 payments of $150
Or 6 payements of $80
Or Scholarship with 1, 3 or 6 payments



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