Pre-Program Questionnaire

This questionnaire is to help us help you achieve total success in the MISSION of your event.

Please complete all fields that apply, and also send us any printed information you feel would best help us understand your organization such as: orientation manuals, product and/or service brochures, annual reports, newsletters or magazines, etc. Be sure to include any promotional mailings and the agenda for the meeting.


Preliminary Information

First Name		Last Name
Company		Title

Phone		Fax
E-mail		Website

What is the best time to reach you?

I. THE PROGRAM
A. What is your program THEME?
B. What kind of meeting is it? (annual meeting, awards banquet, etc.?)

C. Who is responsible for calling this meeting? (HR, Sales, Marketing?)
Name		Title

D. What is the name and title of Johnny’s introducer?
Name		Title
Phone		E-mail

E. Exact times of Johnny’s presentation? (Please attach program agenda)
Starting		Ending

F. When is the best time for Johnny to do his A/V and Room Check?
Option 1		Option 2

G. What is Johnny’s role in the program (Opening or Closing Keynote, Luncheon Speaker, Breakout, etc.)?

H. Is a photograph and/or program blurb needed for advertising purposes? Yes: No:
If Yes, to whom should it go?
Name		Title
Phone		E-mail

I. Who are the other professional speakers on this program?
Speaker 1		Day & Time
Topic

Speaker 2		Day & Time
Topic

J. What professional speakers have you used in the past?
Speaker		Date
Speaker		Date
Speaker		Date
Speaker		Date

K. What did you specifically like about their performance? Why?

K1. What did you specifically NOT like about their performance? Why?

L. Would you like information about Johnny’s learning materials to reinforce the impact of Johnny’s ideas after his presentation? Yes: No:

II. Logistical Information
A. What is the nearest major airport to the meeting site? Distance to meeting site from the airport? Miles: Estimated time:

B. For transportation from the airport to the meeting site would you prefer:
To have Johnny met at the airport? Where
To have Johnny take a cab? Approximate cost
N/A (Local Chicago Area)
Other

C. Exactly where is the meeting?
Venue
Address
City		State/Prov
Phone		Fax
Website		Meeting Room


D. Where will Johnny be staying?
Hotel
Address
City		State/Prov
Phone		Fax
Website		Meeting Room

E. VIDEO Will you be using Image Magnification (IMAG)? Yes: No: Will a video crew be on site? Yes: No:
Video Co.		Contact Name
Phone		E-mail

F. If Johnny has any problems/emergencies on his way to the program, who should he contact? (Please include business, cell, and home number)
Name		Business
Cell		Home

III. Audience Analysis
A. Audience
Attending		Spouses?	Yes: No:
M/F Ratio	%/%	Average Age
Job Titles

B. Toward which group should Johnny primarily direct his presentation, and why?

C. What are the names and numbers of four people Johnny can contact for customization?
Name		Phone
Name		Phone
Name		Phone
Name		Phone

D. What is the greatest challenge your organization is facing?

IV. Background Information
A. What are three things you want people to remember when the presentation is completed?
1.
2.
3.

B. Are there any issues that should be avoided?

C. What three main things should Johnny know about your group?
1.
2.
3.

D. Is there any jargon Johnny should be familiar with (acronyms, titles?)

E. On which target markets/industries does your organization primarily focus?

F. Who is your typical customer?

G. What is the primary product/service that you sell?

H. Who are your major competitors?

I. Any additional comments or information that would be helpful in tailoring the presentation for your group?

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Preliminary Information

I. THE PROGRAM

II. Logistical Information

III. Audience Analysis

IV. Background Information