Working together on this questionnaire will help customize my presentation to meet the specific needs of your organization, its goals and mission. Please answer all applicable questions and return to my office at least 30 days prior to your meeting. Thank you for taking the time to insure that your conference will be a success and surpass your expectations. If you prefer, you can submit this questionnaire and it will email me your response.
Your Conference: Date:
Contact Person*:
Voice Phone*:
Email*:
* required
1. What are your objectives and desired results for my presentation? Objectives:
Results:
2. What is the specific purpose of this meeting (awards, annual meeting, etc.)
3. What is the mission statement of your organization? Please enclose any brochures that participants will be familiar with.
4. What are the current problems/ challenges/ and breakthroughs in your: (1) organization (2) industry
5. What are the major changes or recent announcements in your organization/ industry I should be aware of?
6. What are the top challenges that participants are facing? Are there morale issues that should be addressed?
7. What areas of employee performance need improvement or deserve recognition?
8. What special jargon, titles or terminology should I be aware of?
9. Are there any terms or issues I should avoid?
10. Please provide the names, titles and telephone numbers/E-mail of at least 3 participants/ employees I can contact as a sampling of your organization’s/ industry’s needs, achievements and concerns. [ You may wish to E-mail all participants inviting them to express their training needs and to contribute to the format of the program. I can send you a letter that can be forwarded.]
Name: Title: Tel./email: Name: Title: Tel./email: Name: Title: Tel./email: Name: Title: Tel./email:
11. What will take place immediately before and after my presentation (another speaker; business announcements, break, meal)? Please indicate the topic of any preceding meetings or speeches. Before: After: What meetings will be taking place in adjacent rooms? Who is responsible for checking with the hotel to insure that noise from the next room will not drown out our meeting?
12. Overall meeting time: Begins Ends My Program: Begins Ends
13. Introductions Name of my introducer: Title: Tel./email: Name of executives/ officers at this meeting: Name: Title: Name: Title: Name: Title:
14. Audience statistics No. of attendees: Average Age: Men % Women %
Audience make-up: Board of Directors % Senior executives % Entrepreneurs % Office/sales reps % Clerical/supportive % Positions/ job titles represented:
15. Expected program design: inspiration % applied/practical/high content % entertaining % group exercises and participation %
16. What must I accomplish and what expectations should I meet or surpass, to receive excellent ratings from you, your CEO, and your audience?
17. Top people to recognize in the audience for outstanding performance or special achievement as it relates to my topic: Name: Title: Reason: Name: Title: Reason: Name: Title: Reason:
18. Meeting Location: Address City Hotel Address: Tel: Closest Airport: Miles from site Best transport from airport: Name and telephone (if someone is meeting me)
19. Who is in charge of logistics — room setup, microphone, lighting, and last minute changes? Name: Work # Home # Cell phone #
20. Who should I contact to notify of my arrival or in case of a delay during transport? Name: Work # Home # Cell phone #
21. Please send me any of the following that is appropriate: (Check which ones I should look for)
annual report mission statement organization chart association newsletter meeting agenda association magazine product brochures recognition programs
THANK YOU FOR YOUR TIME AND EFFORT TO MAKE THIS YOUR BEST PROGRAM EVER.
I can guarantee a successful presentation if I have your help coordinating logistics, goals, expectations and desired outcomes!
