Pre-Program Questionnaire

Organization:

Program Date:

Client Name:

Title:

Email Address:

Phone Number:

Website Address:

What is the type of event and specific purpose?

What is the total number of attendees?

What is the ratio of male to female and the average age?

Are the spouses invited?

Please provide a general description of the audience:

What are some of the professional challenges facing the individuals in the audience?

Describe the most significant changes this group has experienced during the last twelve months:

What are some of the accomplishments this audience has attained?

Do you have a theme for the event?

What is your organization's mission statement or company philosophy?

Are there any difficulties currently being faced by your industry?

Please provide the specific objectives you desire from my presentation:

What takes place immediately before the program? (meal, break, another session/speaker)

What takes place immediately after the program? (meal, break, another session/speaker)

What date and time will the conference begin?

What date and time will the conference end?

What time will my presentation start and end?

Who will be introducing me? (Name & Title - Introduction will be supplied)

What is the appropriate attire? (i.e. - Formal, Casual, etc.)

What is the address of the event?

What is the phone number of where the event will be held?

How many miles is this from the airport?

How will I be transported from the airport to the meeting site / hotel? (i.e. - rental car, taxi, limo, other)

Who is my emergency contact?

Emergency contact business phone number:

Emergency contact cell number:

Emergency contact home phone number:

What is the name of the hotel in which I will be staying?

What is the address of the hotel?

What is the phone number of the hotel?

Will this hotel room be billed to your master account?

Reservation confirmation number:

Whom should I contact upon my arrival at the meeting site / hotel?

Please provide the following materials in advance, if available. Please check those you can provide:

Annual Report Meeting agenda or invitation Newsletter and / or industry magazine Promotional material on event Script of speeches given by representatives of your organization. (i.e. - Chairman's, National Sales Manager, etc.)

Would you be interesed in the personal development materials I have available, such as my books, "How High Can You Bounce" or "Playing From The Heart" for each of your audience members?

Yes No

Is there any additional information that I should know?

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