Pre-Program Questionnaire

Fill out the form below Contact Information Name: Title: Email Address: Phone: Company Name:   Event Information Event Name: Event Theme: Event Location: Number of Attendees: Keynote or Break-Out Presentation? Keynote  Break-Out Title of Program: Time of Program: Amount of Time Colette with speak: Who will introduce Colette (intro will be sent):   Transportation/Lodging Information Hotel Confirmation Number: Will the hotel be direct billed to your master account? Yes  No Emergency Contact Number: Transportation to/from event:   Room Set up Room Name (location): What is the stage background and room set up:   Other Program Info Are there any events the night before? Yes  No What takes place immediately preceding session: (speaker, meal, workshop)? Other speakers/Topics at event: (speaker, meal, workshop)? Will audience members be eating during presentation? What takes place immediately following Colette’s program? What takes place immediately following Colette's program? Who has spoken in years past?   Audience Info Audience member attire: General age of audience: Demographics: % of men: % of women: Describe audience members' jobs or specialties: Issues to avoid (if any): Main ideas to focus on: Suggestions to make this program even better: Current challenges in your group: Most important thing you want your attendees to take away from this presentation: Main sources of joy: Any inside stories to share: Who are some "characters" within your group everyone knows and what makes them memorable? Any jargon or catch-phrases for this group I should know? What is their biggest annoyance or pet peeve? Is there a running inside joke? Is there someone who is always (fill in the blank with someone who popped in your mind)? Anything else I need to know to make this an incredible success?   Sales Programs Who do attendees see as their competition? If they say they are not having success, what are they saying is the reason? What do you believe is the reason?   Please provide between 3-5 attendees names/numbers/email addresses that I might get in contact with for customization (ideally a couple of top performers, a middle performer and a couple low performerswho you believe have potential): Name: Title: Phone: Email: Name: Title: Phone: Email: Name: Title: Phone: Email: Name: Title: Phone: Email:   Security code: Reload Image   Thanks again for taking the time to complete this form. It helps make the event a great success!