Pre-Program Questionnaire
The more we know about you, your group, and your organization the better the program! The answers to the following questions will help us custom tailor our presentation to the needs of your audience and will assist in keeping your schedule on time. Remember, we don't deduct for grammar! Please print. We would also appreciate receiving any information on your group that may help us with background (e.g., corporate reports, publications, services, etc.) Thank you for your help!
This pre-program questionnaire is for Steve Kissell's presentation on____________ for ____________________________________ .
THE PRESENTATION
Presentation title: _____________________________
Any breaks? Yes or No
Time: __________________
What is on the program just before I speak?
________________________________________________________
What is on after me?
_______________________________________________________
Appropriate dress for presentation?
_________________________________________________________
Meeting title and theme?
_________________________________________________________
Sensitive issues that should be avoided?
________________________________________________________
What specific objectives can I help you to accomplish at this meeting?
_________________________________________________________
Introducer's name: ______________________________
Introducer's phone: (wk) ___________________
What speakers have you used in the past that covered topics related to the
material I will be presenting for you?
_______________________________________________________
If I could wave a magic wand to solve a problem or to improve the climate in
your organization, what would it be?
_______________________________________________________
How can I go that extra mile or add a special touch to this program?
_______________________________________________________
Special jargon or terminology
________________________________________________________
________________________________________________________
What is the mission/philosophy statement for your organization?
_______________________________________________________
________________________________________________________
How long has the organization been established?
_________________________________________________________
Key person(s) I can contact to get additional inside information:
_________________________________________________________
_________________________________________________________
Are there any people you would like me to recognize? Please include reason,
if desired.
_________________________________________________________
_________________________________________________________
What are the most humorous events that have occurred within your organization
during the past year?
_________________________________________________________
_________________________________________________________
_________________________________________________________
PLEASE PROVIDE INFORMATION ABOUT YOUR AUDIENCE.
Number in the audience? ______
Age range _______
Educational Backgrounds _________________________________
Percent Male: ___________ vs. Female: ___________
# New people: ___________ vs. Veterans: ___________
Will there be any special guests? Y N
Please explain:________________________________________
Voluntary, mandatory, etc. ____________________________
Two names of good-natured people that I could use to participate in the program.
Please note: It is important that any participants that we use are well known
to the group and would enjoy the attention. Plus, they get a great gift from
me!
(1) ______________________ Title ___________________________
(2) ______________________ Title ___________________________
* Since my program is interactive and tends to get quite loud,
please do not schedule speakers in adjacent rooms during the
program if possible.
Thanks for your help in making my presentation a success!
Steve Kissell