Executive Communication Academy Application Form

Thanks for your interest in Executive Communication Academy. This is a 1:1 program for founders and executives who want their communication to match their leadership.

This form takes about 10 minutes. Be specific. The more I know about where you are now, the better I can recommend where to start.

This program is not the right fit if:

-You are looking for pitch coaching (Deliver Your Deck is a better fit) -You’re looking for a general English or grammar class -You aren’t able to commit to weekly sessions and work between them

Section 1: About You

1. Full Name

2. Email Address

3. LinkedIn Account

4. Company Name and Website

5. Where are you based? (City and country)

6. What’s your first language? If you speak more than one, list them.

7. What is your English proficiency level?*

Beginner (A1-A2) - I struggle with basic conversations

Intermediate (B1) - I can have conversations but make frequent errors

High Intermediate (B2) - I'm comfortable in most business situations

Advanced (C1) - I'm fluent but still working on polish and confidence

Bilingual/Native (C2) - English is essentially a first language for me

Section 2: Your Role

8. Your Role or Title

9. What does your company do? Explain it the way you would to someone outside your industry.

10. What does your role involve day to day? Who do you communicate with most?

11. Has your role changed recently, or is it about to?

Section 3: Communication Challenges

12. What are your biggest communication challenges right now? (Check all that apply)

13. If you checked 'other', please describe

14. Describe one recent moment when your communication didn’t land the way you wanted. What happened? *

15. Six months from now, what do you want to be doing differently?

16. Why do you think we'd be a good fit to work together

Section 4: Logistics

17. I’m based in Calgary, Canada (Mountain Time). Sessions are weekly, on a consistent day and time. List 2–3 days and time windows that work for you, in your local time.

18. Aside of our one hour weekly session, how much time can you set aside each week for preparation and practice?

Less than 1 hour

1–2 hours

2–3 hours

3+ hours