Request Jamie

Pre-Program Questionnaire
This questionnaire is designed to help us prepare a program that is specifically tailored to the needs of your group.  Please take a moment to fully answer all the questions, and submit the form to our office.  Thank you.
Special request: Please send me as much information as possible to help increase my understanding of your organization. This includes association magazines, news releases, newsletters or other information you feel would be of value, if it is applicable.
Audience Analysis Information:

Number of attendees?

Spouses invited?

 Yes   No

Number of Males?

Females?

Average age of group

Range of age

 From to

Major responsibilities of audience members:

What are the names/titles of your top people who will be at this meeting?
The Program Itself:

What is your specific objective for my session?

Are there any issues/topics in particular that you think I should discuss during the program?

Key issues to avoid (if any):

Name and title of my introducer:

Starting times for My program

 AM PM

Ending times for MY program

 AM PM

What takes place before my program (speaker, meal, workshop)?

What takes place immediately after MY program?

If other speakers are on the program with me, who are they and what are their topics?
General Background Information

What do you consider the primary strengths of your organization/people?

What are some current problems experienced by your industry/organization/people?

What areas of their overall working performance are ripest for improvement?

What are the most significant events to have occurred in your industry/organization/group during the past year? (i.e.: expansion, relocations, reduction in force, new laws, etc.)

What are the top three challenges faced by the people who will be in my audience?

Please share with me any "industry color" (i.e.: promotions, unusual regulations or policies, Murphy's Law in action, etc.)

When your people depart from this presentation what ONE thing do you want to be uppermost in their minds?
Logistics

Where is the meeting being held? Actual physical address.

Will the program be held in a hotel, office conference room, other?

What is the room set up (i.e.: long tables, round tables, classroom style?)
After receipt of this form, I can better determine my additional audio/visual needs and will get back with you concerning those.