Pre-Program Questionnaire

Thank you for your time and supplying this information.  

With this guideline of information, we will better serve you and give you a personal
customized presentation. 

 Any other information you can provide will be happily received. 

Please complete this form and click the "submit" button to help Sharol prepare the
best possible program for you.
*'s denote Required Fields

First Name:	*
Last Name:	*
Company / Association Name:	*
Address:
City:
State/Province:
Zip/Postal Code:
Country:
Area Code:	*	Phone:	*
Email Address:	*
Fax:
Web Site:
Meeting Date:
Length of Talk/Workshop:
Meeting Type (Convention, Sales, etc.:	*

I. PROGRAM:

A. What is your program THEME?



What does the theme mean to your group?

B. What kind of meeting is it? (continuing education, convention, annual meeting, awards banquet, etc.?)

C. Who is responsible for calling this meeting? (Education, Specific Department, HR, Sales, Marketing?

Name:
Exact Title:
Email Address:
Phone:

Address if different from contact:

D. Who is the President/Executive Director?

Name:
Exact Title:
Email Address:

Address if different from contact:

E. Who is the V.P. of specific area? (Education, Nursing, Support Staff, Sales, Marketing)

Name:
Exact Title:
Email Address:

Address if different from contact:

F. What is the name and title of Sharol's introducer?

Name:

  Title:

G. Exact times of Sharol's presentation? (Please attach program agenda)

Starting:

Ending:

H. When is the best time for Sharol to do her A/V and Room check?

Option #1

Option #2

I. How should Sharol dress for her presentation?

Casual suit
Casual wear (or client provided "theme shirt")
Business suit

J. What is Sharol's role in the program (Opening or Closing Keynote, Luncheon Speaker, etc.)?

K. Which company executives, if any, will be speaking before Sharol?


Please forward transcripts of their speeches for Sharol to read and use to tailor her speech.

L. Who are the other professional speakers on this program?

Speaker:
Topic:
Day:

 

---

Speaker:
Topic:
Day:

M. What professional speakers have you used in the past?

Speaker: Year:

Speaker: Year:

Speaker: Year:

N. What did you specifically like about their performance?
  

O. Would you like information about Sharol's learning materials to reinforce the importance of Sharol's ideas after her presentation?
Yes No

II. LOGISTICS

A. What is the nearest major airport to the meeting site?  Is it non-stop or require a connection in another city?



Distance to meeting site? Miles:  

                                   Minutes:

B. For transportation from the airport to the meeting site would you prefer:

To have Sharol met at the airport?
Where?

To have Sharol rent a car?
 Which national car agency?

To have Sharol take a cab?
Approximate cost?

N/A (Local Meeting)

Other

C. Exactly where is the meeting?

Hotel
Address
City
State
Zip
Phone#
Fax#
Meeting Room:

D. Hotel where Ms. Tyra will be staying, if not the same as meeting?

How far away is this hotel from the meeting location?

E. Will an LCD Projector (Infocus or Epson) be available for her PowerPoint Presentation?
YES     NO

F. If Sharol has any emergencies or flight delays on her way to the program, who should she contact? 

      Name:  
 Business:
   Cellular:
      Home:

G. To be at her best, Sharol typically prefers to have dinner from room service and retire early the evening before her presentation. If there is a scheduled function the evening prior, please let us know time, place, nature and appropriate dress:

III. AUDIENCE

I. Name:
Title:
Phone:
Email:
II. Name:
Title:
Phone:
Email:
III. Name:
Title:
Phone:
Email: