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Pre-Program Questionnaire
This questionnaire is designed to help us prepare the best
possible customized presentation.
Please return to
us no later than_____________________. Thank you!
Name of Group:____________________ Date of
Presentation:______________
Person completing this form:_________________ Phone:
(____)_____________
Fax #: (_____)_________________________ Email
address:_______________
WWW address if
any:______________________________________________
Meeting Time: Begin___________ End___________
My Program: Begin___________ End___________
2nd program: Begin__________End__________
Meeting Location:________________
Address: ______________________
City:__________________________
Hotel Address:_________________Phone#:_________________Fax#_______
Closest Airport:___________________ # miles from
site___________________
Would you prefer that I dress: In a suit?________Business
Casual________Casual?_________Other?___________
Approximate Number attending meeting:______ f______(%)
m______(%) Age range:___________
General job responsibilities of
attendees:___________________________________________________
___________________________________________________________
___________________________________________________________
If this
presentation is part of a conference, what is the theme, if
any?________________________________________________________
What is the mission/philosophy statement for your
company/organization?
____________________________________________________________
____________________________________________________________
What are some problems / breakthroughs / challenges currently
experienced by
your company or industry?
____________________________________________________________
____________________________________________________________
____________________________________________________________
____________________________________________________________
What changes have taken place in your organization / industry in
the last few
years? _______________________________________________________
____________________________________________________________
____________________________________________________________
_____________________________________________
What changes do you anticipate in your organization / industry
in the near
future?
____________________________________________________________
____________________________________________________________
____________________________________________________________
____________________________________________________________
What are the top challenges faced by people who will be in the
audience?
____________________________________________________________
____________________________________________________________
If there is a
special program or project you are currently conducting within
your organization or department, please briefly describe its
name, nature,
and any accompanying slogans:
___________________________________
____________________________________________________________
____________________________________________________________
What is unique about your group? (i.e.: seasonal work flow,
special clientele,
unusual hours, travel, red-tape, communications...)
____________________________________________________________
____________________________________________________________
____________________________________________________________
____________________________________________________________
What phrases/sayings do executives frequently
use?___________________
____________________________________________________________
Please list any in-house or marketing specific language, jargon,
phrases, or
words applicable to your group that might be incorporated into
this
presentation:
______________________________________________________________
______________________________________________________________
Is there anything of significance that this group can be proud
of
accomplishing as a group?
______________________________________________________________
______________________________________________________________
Specifically, what "local color" should I use in my
presentation? This could
be anything, such as a new company policy, an in-house buzzword,
a local
drinking place, poor food, and a broken piece of equipment,
local weather, or
achievement of a top official in your organization.
_____________________________________________________________
_____________________________________________________________
Overall objectives of meeting or conference:
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
Specific objectives for Mike's talk:
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
Any seeds you
would like Nancy to Plant:
_____________________________________________________________
Top People to recognize in the audience or people to poke "fun"
at:
Name: ________________________________
Title:____________________ Reason:_____________
Name:________________________________ Title:____________________
Reason:_____________
Please list the names of two accomplished professionals within
the group
that Nancy could call to get additional perspective.
Name:________________________________ Title:___________________
Phone #:____________
Name:________________________________
Title:___________________ Phone #:____________
Schedule - What's happening before & after
talk?_________________________________________________________
_____________________________________________________________
Will there be other speakers?______Topics:___________________________
_____________________________________________________________
Please list past
speakers:__________________________________________
Introducer - (name &
title):________________________________________
Is is possible for one or two guests to sit in on Nancy's
program?______________
May Nancy offer his books and tapes for sale following his
program?________ He will never "hard sell."
Note: Please send a copy of all memos, program announcements,
brochures, and other promotional materials relating to this
presentation so our presentation will be consistent with your
promotion. In addition, any annual reports, a company
newsletter/paper/flyer, or any key product brochures would be
appreciated, if available.
Thank you very much for helping us customize our presentation
for your group! |
