"The People Professionals"
Wilkins & Associates
P. O. Box 22
Park Forest, IL 60466
ph: 708-785-7371
Clientca
We thank you for taking time to visit us, we ask that if you need any additional information, wish to order any product or services we offer, or simply want to provide us with your comments, questions or suggestions, we look forward to hearing from you and assure you that your input is valuable.
Registration - If you wish to register for any upcoming training (i.e. "Reentry Training", etc.) please fill out the "Contact Form" to the right and submit it, please indicate in the comment box which training you are regoistering for. if you have any questions about your registration, call us at 708-785-7371.
Speakers Associations - If you are interested in membership in any of the speakers associations, please fill out the application, the same application may be used for any of the speakers association.
Products - To order any product you may order by Credit Card over our secure web site using Pay-Pal, or you mail us a check or money order to: Wilkins & Associates, at P. O. Box 22, Park Forest, IL. 60466. All checks and money orders whould be made payable to: "Wilkins & Associates", Please send us complete shipping instructions and the address.
Services - If you are interested in any of our professional training or consulting services, please contact us at (708) 785-7371 or email us at clientcare@wilkins-associates.com, to schedule a no cost, no obligation consultation.
Questions, Comments & Suggestions - We value your opinion and gurantee your satisfaction, so please feel free to complete the "Contact Form" and provide us with your questions, comments or concerns. Someone will respond to you in less than 48 hours, on business days.
Thank you for visiting us, tell someone about us, and let us serve them too.
WILKINS & ASSOCIATES
SPEAKERS' ASSOCIATION MEMBERSHIP APPLICATION
(Select which association you wish to join)
___THE NATIONAL AFRICAN AMERICAN SPEAKERS ASSOCIATION (NAASA)
___THE SPEAKERS PUBLISHERS & AUTHORS ASSOCIATION (SPAA)
___ THE YOUNG SPEAKERS ASSOCIATION (YSA)
___ THE HISPANIC SPEAKERS ASSOCIATION (HSA)
P.O. Box 22 * Park Forest, IL 60466 * 1-708-785-7370
Name:_________________________________________________________________________
Address:_______________________________________________________________________
City:______________________________ State:________________ Zip Code:______________
Home Phone:_______________________________ E-Mail Address:______________________
Name of Company/Organization:____________________________________________________
Work Address:_________________________________________ City/State:________________
Work Phone: Ext. Fax #:
Professional: Annual dues $199.00 (You must have earned or been appointed to this level)
Effective: Annual dues $ 99.00 (All new members join at this level)
Student: Annual dues $ 50.00 (Current students between the ages of 18-25)
Youth (YSA) Annual dues $ 35.00 (Young Speakers Association, ages 8-17)
Fee enclosed: $__________ Method of Payment:___ Cash __ _ Check____ Visa___ M/C____ Other
Credit Card #____ _Exp.Date:_____________
Signature (Required for credit card):_________________________________________________
Personal Information: (Optional) Date of Birth:___________________ Marital Status:__________
Educational Level:________________ (Degrees must be verified) Major:___________________
Current Profession/Job:_____________________________________ Number of years:
Recommended by:________________________________ Chapter:________________
Please indicate below your speaker topics or areas of expertise: (i.e. motivation, cultural diversity, customer service, etc.)
Speaking Topics: 1.______________________________
2._______________________________________________
3. _______________________________________________
Please provide an 80 word (maximum) "BIO" (biographical summary) of your expertise on a separate sheet of paper (you may send this information to our office at a later date.) This information will be included in the annual speaker's Membership directory. If you do not provide this information your listing in the directory will be limited to your name only.
Make all checks payable to Wilkins & Associates, please print & return this application to our offic: Wilkins & Associates * P.O. Box 22 * Park Forest, IL 60466. You may also join via our Web Site at: www.wilkins-associates.com. (Contact form)
JOIN TODAY!_____
For Chapter/National Use Only
Chapter Assignment:______________________ Date:__________ Payment Rec. By:_____________
National Number Assigned:________ Date Rec'd by Nat'l:__________ Nat'l Rec. By:____________
Comments/Instructions:
Wilkins & Associates CONTACT FORM -
Wilkins & Associates
P. O. Box 22
Park Forest, IL 60466
ph: 708-785-7371
Clientca