Pre-Program Questionnaire for George E. Curry
To help me properly prepare for your event and customize my message, please complete this form.
Your Name ______Company ______
Title ______Telephone Number ______
E-Mail Address ______Company’s Web Site ______
I. The Program
a) What type of meeting will this be? (annual convention, awards banquet, etc.)
b) What is your program’s theme?
c) What is my role in the program? (Opening speaker, Closing keynote, luncheon, etc.)
d) Who are the other speakers on the program, if any?
e) Who was the speaker for this event last year?
f) What takes place on the program immediately before and after my presentation?
g) What time does the program begin and end?
h) Is there a reception prior to the event? If so, when and where?
i) What did you particularly like or dislike about past speakers?
j) Are there any particular issues I should be sure to address or avoid?
k) What do you hope to accomplish with my speech?
l) How did you learn about me as a speaker?
m) Why did you select me?
n) What is the appropriate dress for the event? (business, formal, etc.)
II. Audience Demographics/Research
a)Expected size of audience? ______
b)Percent male? ______Female? ______
c)Age range _____ to ______
d)Spouses invited? Yes ____ No _____
e)General description of the audience?
f)What do most of these people do on a daily basis?
g)Toward which group should I primarily direct my presentation?
h)What are three key things that I should know about your group?
i)Give me the names of telephone numbers of three people willing to give me a feel for your organization (Please advise them that I will be calling).
(1) ______
(2) ______
(3) ______
III. General Background
a)What are the current “hot issues” in the industry or community?
b)Is there any jargon or acronyms that I should be familiar with?
c)What is your company’s competitive advantage? (Why do people do business with you?)
d)What has been the most significant events that have occurred in your company/group/industry recently?
e)What separates your top performers from the others in your organization?
f)What are the primary products that you sell?
g)Who is the typical customer?
h)What is the greatest challenge facing your company/industry?
i)What must your company/organization do to meet that challenge?
j) Please send me the past three or four company newsletters/newspapers so that I will be more familiar with your group.
IV. Logistics
a)Primary Contact
Name
Title
Address
City, State, Zip
Office Phone
Home Phone
Mobile Phone
b)Alternate Contact
Name
Title
Office Phone
Home Phone
Mobile Phone
c)On-Site Contact
Name
Title
Mobile Phone
d)Event Location
Place
Address
City, State, Zip
Building/Room/Hall
Distance from hotel
Telephone
Fax
e)Accommodations
Hotel
Address
City, State, Zip
Confirmation Number
Telephone
Fax
Direct billed or Pre-paid?
Distance to Airport
Distance to Event
f)Ground Transportation
Name of Airport
Name of Limo Company or Car Service
Driver/Greeter
Phone
Mobile Phone
Confirmation Number
Where meeting me (Gate or baggage claim area?)
Additional comments/tips/observations:
Fax this completed form to 610/980-5073
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