Pre-Program Questionnaire

This questionnaire is designed to help me prepare for my upcoming presentation with your organization. Please complete as many of the questions that are applicable to your group. After I have received this information, a phone appointment will be scheduled to discuss it further. THANK YOU!

Program Date
Client Name

1. Please provide a general description of the audience.

2. What is the total number of attendees?
What is the ratio of male to female and the average age ?
Are the spouses invited? Yes Number:

3. Type of event and specific purpose:

4. Do you have a theme for the meeting?

5. What is your organization's mission statement or company philosophy?

6. Please provide the specific objectives you desire from my presentation.

7. What are some of the professional challenges facing the individuals in the audience?

8. Are there any difficulties currently being faced by your industry?

9. Describe the most significant changes this group has experienced during the last twelve months.

10. What are some of the accomplishments this audience has attained?

11. Other speakers presenting at this event:

Previous speakers used:

 12. What takes place immediately before and after my program (meal, break, another session/speaker)?
Before: After:   

13. What dates/times will the conference begin and end?
Begin:   End:     

14. My presentation will

begin at end at   

15. Who will be introducing me? (Introduction is supplied)
Name:   Title:    

16. Name and address of meeting location:
Phone Number:
Distance from the airport

17. How will I be transported from the airport to meeting site/hotel?
Rental Car

18. Name and address of hotel in which I will be staying?
Will this hotel room be billed to your master account? Yes
Confirmation Number:

19. Whom should I contact upon my arrival at the meeting site/hotel?
Name: Telephone number:

20. Emergency Contact?
Name Business number
Home number Cell number

21. What is the appropriate attire?

22. Please provide the following materials in advance, if available. Check those you can provide.
Annual Report
Meeting agenda or invitation
Newsletter and/or industry magazine
Promotional material on event
Script of speeches given by representatives of your organization.
(Example: Chairman's, or National Sales Managers speech.)

23. Is there additional information that I should know?

You can also print and fax or mail:
Kimberly Goddard President, Proper Protocol, Inc.
PO BOX 26127 Tampa, FL 33622
727-593-7478 Facsimile