This questionnaire below and other resources are for meeting planners who have already booked me as their speaker. The questionnaire is for collecting information on your organization in order to customize my presentation to meet your specific goals.
The more I know about your organization, the better I can relate my experiences to your participants and connect with them. Please send as many of the following items as soon as possible. Please place my name on your mailing list. I would like to continue to receive your organization's information up the event date. I promise to read everything!
Please answer all questions as fully as possible. After I receive this information, I look forward to discussing your meeting details with you by phone. I will contact your office to schedule a phone meeting date and time.
Thank you for your time. I look forward to speaking with you soon!
General Info
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| Your Organization: |
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| Website URL: |
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| Meeting Date: |
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| Meeting Topic & Title: |
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Event Information
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| What is the purpose and theme of this meeting/event? |
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| What does the theme mean to you and your attendees? |
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| What is the most important objective for this event? |
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Professional speakers or outside experts previously used
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| Name: |
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| Topic: |
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| Name: |
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| Topic: |
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| Please comment on previous speakers effectiveness...what you liked about their specific presentation. |
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Audience
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| Number of attendees: |
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| Average age: |
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| % Male: |
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| % Female: |
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Audience make-up
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| % Senior Executives: |
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| % Middle Management: |
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| % Office/Sales Reps.: |
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| % Support/Clerical: |
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| % Entrepreneurs: |
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| % Guests: |
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| % Spouses: |
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| Any recent successes that attendees are proud of? |
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| Any current problems or challenges that attendees are experiencing? |
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| Any important things I should know about the attendees? (personality, work environment, competition, current pressures, fears) |
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Organization/Company
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| What is the mission statement for your organization/company? |
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| Any recent successes or breakthroughs your organization is proud of? |
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| Any current problems or challenges your organization is experiencing? |
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| What separates the high performers from others in your organization? |
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| Any significant recent events I should be aware of concerning your organization? |
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My Program
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| What are your objectives for my presentation? |
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| Any issues I need to be aware of? Any topics I should avoid? |
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| What special jargon or terminology should I be aware of? |
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| Name of my introducer: |
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| Their title: |
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| Phone: |
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Schedule
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| Beginning Time: |
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| Ending time: |
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| Scheduled set-up time: |
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| Do you want a 'question & answer' session at the end? |
YES NO |
| What percent of my program should "how-to" ideas with "take home" value? |
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| And what percentage do you want to be motivational & inspirational? |
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If there are other speakers before and/or after me, please provide their names and topics
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| Speaker before me: |
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| Topic: |
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| Speaker after me: |
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| Topic: |
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| List other scheduled events you would like me to attend, i.e. meals, interviews, autograph sessions, etc. |
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| What else must I know to make my presentation a success? |
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| How do you judge success? |
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Please list senior executives, managers or other organization members I can phone for additional information. If possible, the list should reflect the makeup of the audience.
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| Name: |
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| Title: |
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| Phone: |
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| Name: |
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| Title: |
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| Phone: |
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| Name: |
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| Title: |
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| Phone: |
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Dress Code
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| Business Attire Business Casual Black Tie Resort Wear |
Please select the best audio/visual equipment set-up for your meeting
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LCD Data Projector Unit
Capability to hook into main sound system from computer
Large screen - 10' x 10' / 12' x 12'
Cordless microphone
Draped round table |
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2 Kodak Slide projectors
Dissolve unit w/ remote control
Large screen - 10' x 10' / 12' x 12'
Cordless microphone
Draped round table |
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