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Pre Program Questionnaire

This pre-program questionnaire is for Elaine Wilkes's Presentation ______________ on __/__/___.

These questions are designed to help us prepare a program specifically suited to the needs of your group. Please take a moment to answer all the questions fully and email back to [email protected] no later than __/__/___.

We would also appreciate receiving any printed information on your group that may help us with background information, (e.g., corporate reports, news items, in house publications, prod cuts, services, employees, etc.). Thank you for your help!

If you have any questions please call 818 888 2823 or 310 447 8446.

THE PRESENTATION

Presentation title:

____________________________________________________________________________________________

Time Frame? Start time: _______________End Time:____________________Any breaks? Y N

What is on the program before I speak?

____________________________________________________________________________________________

Appropriate dress for the presentation?

____________________________________________________________________________________________

Conference title and theme?

______________________________________________ Specific purpose of this meeting/session (e.g., awards, banquet, annual meeting, etc.)

______________________________________________

Specific objectives for my presentation?______________________________________________

____________________________________________________________________________________________

____________________________________________________________________________________________

Sensitive issues that should be avoided:

____________________________________________________________________________________________

Introducer's name?____________________________________________________________________________________________

Introducer's Phone number: ____________________________________________________________________________________________

Who are the speakers and topics on the program?

____________________________________________________________________________________________

____________________________________________________________________________________________

What speakers have you used in the past that covered topics related to the material I will be presenting?

____________________________________________________________________________________________

____________________________________________________________________________________________

What did you like and/or dislike? Withhold their names if you like, but do comment on the material they used.

____________________________________________________________________________________________

____________________________________________________________________________________________

____________________________________________________________________________________________

What comments or suggestions do =you have that will help me make this presentation the best your audience has ever had?

____________________________________________________________________________________________

____________________________________________________________________________________________

____________________________________________________________________________________________

THE AUDIENCE

Total attending?__ _________Spouses or children attending?_________

Percentage male/female?__ ________Average age? __________
Average annual income__________

Educational background__________

Major job responsibilities of audience__________

 

Will there be any special guests?
______________

 

Why is your group attending this meeting (Voluntary mandatory, etc.)?

____________________________________________________________________________________________

____________________________________________________________________________________________

How will they be notified?

____________________________________________________________________________________________

____________________________________________________________________________________________

 

DETAILS ABOUT YOUR AUDIENCE

Problems?

____________________________________________________________________________________________

Challenges?

____________________________________________________________________________________________

Breakthroughs?

____________________________________________________________________________________________

 

TRAVEL INFORMATION
Location of presentation and venue name

____________________________________________________________________________________________

Address
____________________________________________________________________________________________

v

Phone

____________________________________________________________________________________________

Location at the site (room name, etc.)

____________________________________________________________________________________________

Airport to arrive at
____________________________________________________________________________________________

How will I be transported front he airport to your site?

Taxi? __________ Rental Car? __________ Driver? __________

Driver's Name__________Phone __________

If an emergency occurs ont he way to the site, who would be tan alternative contact if you're unavailable?

Name and Phone:

____________________________________________________________________________________________

Thank you for taking the time to provide this information. I will use it to prepare an outstanding presentation for your group.