Pre-program Questionaire

This questionaire help me prepare a program which is specifically suited to your group's needs. The answers to these questions will enable me to tailor my presentation appropriately.

Please answer the questions as fully as possible and feel free to skip any questions which are not relevant to your group.

After answering the questions, please click the submit button or click here for printable version of questionnaire.

Email Address:
What is the purpose of your meeting? What is its theme?

What are the major challenges faced by the people who will be attending our program?

When does your meeting begin? (date and time)
When does it end?
When is my program?
How would you describe the anticipated audience?
Number of people expected:
% members
% guests or spouses.
Average age:
Range of ages:
Educational background(s):

Sex: % Male % Female

Approximate annual income : $
Is their attendance at your meeting mandatory? Yes No
At my program? Yes No
Other characteristics:
Will there be many people who are different from the description in the previous question? How are they different?

Please describe what the audience will be doing in the hour preceding my program:

What will they be doing after my program?  

What should I know about the people in your group before I start my program? Are there any problems, competition, resentment or peer pressure that I should know about?


What professional speakers have you used in the past? What did they speak on?

What other professional speakers will be presenting at this meeting? What will they speak on? Are they speaking before or after my presentation?
Is there anyone who will be in the audience and who is especially well-known and well-liked, who would enjoy it if I made humorous references to them - in the appropriate situation, of course. Please list their names and titles or positions:
Please list the names and titles of your TOP people who will be at my program?
What significant events have occurred within your industry or to your group during the past year?
What interesting events (they don't necessarily have to be 'significant') have occurred within your industry or to your group during the past year?
What are you trying to accomplish with this meeting?
Why do you think I'll be an asset to the meeting?  
What are you hoping to accomplish with my particular program?
How would you like the audience to feel when they leave my session?
What idea(s) would you like the audience members to learn from my program?
Are there any particular topics or issues that I should address during my program?
Are there any sensitive issues that I should avoid?
Please list some industry-specific terms, phrases, jargon, or acronyms that I might incorporate into my presentation:
Do you have any suggestions to help me make this program successful?
If I have any problems getting to the program, who should I contact? Please provide business, beeper, and home phone numbers:
Please provide the name and title of my introducer and how I can contact him/her:

I have found that audience members want to take something home with them, to continue the learning process. I offer a number of learning materials, including books, CDs, articles and workbooks:


How do you want to handle this post-program learning?

group purchase of materials at discount
deliver before the program
deliver at the end of the program
make material available for individual purchase
order form at each seat
materials sold at back-of-room
When returning this questionnaire, please also send me any printed material (newsletters, brochures, annual reports) on your group or your industry. This will help me to customize my presentation.
Please send some blank stationery for your organization (or other material containing your organization's logo) so that I can personalize my materials for your group.
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