This questionnaire is designed to ensure the day runs according to your expectation. Thank you for taking the time to fill it out.

Please return this at your earliest convenience via email.

Please note that all information will be kept in the strictest of confidence.

Pre Event Questionnaire
Event information
Organization Name: / Organization name
Name of Event: / Name of Event
Exact Address of presentation: / Street Address
City, Province/State
Other Helpful Notes
Contact Person: / Contact Person
Phone Number for the day: / Phone Number
Alternate Contact: / Alternate Contact
Engagement Date(s): / Pick the starting Date
Pick the last date of the event.
Time of Presentation / Enter start – end time
Enter break time(s)
Billing Information / Name
Street Address
City, Province/State
Postal Code/Zip
Audience Information
Approximate Size of Audience: / Enter Approx Number Here.
Breakdown of Audience: / Males Females.
Spouses Attending: / ☐Yes ☐No
Average Age of Group / Average Age.
Range of Educational Backgrounds: / From this level.
To this level.
What Occupations are Represented: / Enter list of Occupations separated by commas.
How well do they Know Each Other? / Click here to enter text.
How important is it that they know each other better? / Click here to enter text.
What Percentage would you like Lecture vs Interaction? / Lecture %. Interaction %.
What do you anticipate their mood to be? / Click here to enter text.
Are there anything funny/strange/annoying things that the group all have a chuckle at? / Click here to enter text.
The Event
What will be taking place before, during, after my presentation? / Before Presentation.
After Presentation
Will there be other speakers? Please include names and topics or attach the program please. / Speaker, Topic.
Speaker, Topic.
Speaker, Topic.
Speaker, Topic.
Speaker, Topic.
Speaker, Topic.
Who have been other successful speakers at past events? What specifically did they do that made them successful with your group? / Click here to enter text.
Do you have any other suggestions or ideas to help me make this the best presentation possible? / Click here to enter text.
Please share a few industry terms or “lingo” and their meaning. / Click here to enter text.
What is your desired outcome? / Click here to enter text.
How will you evaluate the program’s success? / Click here to enter text.
Given that you are very satisfied, would you be willing to write a testimonial letter? / ☐Yes ☐No
The oRganization
Taking into consideration this specific organization and the people who belong to this group, what are the: / Current Problems?
Current Challenges?
Recent Advances?
Who would be considered “heroes” to these audience members? They can be from your organization, industry or profession. Please include both the name and the reason. / Click here to enter text.
What is the difference between people in the organization who are at the high end of the excellence scale & those at the low end? / Click here to enter text.
At the end of the presentation how do you want the audience to: / Feel?
One last thing …
If possible can you please provide contact information for 3-5 attendees representing a typical cross section of the group willing to chat with Steph for background clarity who would be for her talk.
Names / Job Title / Phone / Email

Remember to link to your on-line information about your event to help get people excited about the day!

Thank you, I appreciate your assistance with this.

I am looking forward to helping you make this event extra special!

See you there!