Pre-Program Questionnaire

Sites of Interest

Information we'll need from you:

A copy of your meeting agenda
Information and promotional materials sent to attendees for this meeting
Recent company newsletters or publications

Thank you for taking the time to supply us with this information. The more prepared we are, the better we can serve you!

Please complete this form and click the "Submit" button to help Richard prepare the best possible program for you. Or you can print out this form, fill it in and fax it to (941) 828-3604.

Organization Name
Presentation date
Presentation time	From to
Contact person
Email
Office phone
Office fax

Meeting facility Information
Meeting facility name
Meeting facility address
Meeting facility phone
Meeting facility fax

Richard's hotel arrangements (if different from meeting facility)
Hotel name
Hotel address
Hotel phone
Hotel fax
Conference phone

Meeting Information
Type of meeting	Sales Staff Marketing Management Leadership Association
Purpose of meeting
Program theme
Number of attendees
Percentage male/female	Male Female
General job description & demographics of attendees
Names of top producers in company
Background on organization - Corporate Report
The three most significant events to have occurred in your industry or within your group during the past year
The top challenges currently confronted by the members of your group
Major problems that need to be addressed specifically
Specifically, what are you trying to accomplish at this meeting?
What are your specific objectives for Richard's session?
How would you like your attendees to feel after the program is over?
*Are there any topics or subjects not* to be mentioned?**
What three things do you think Richard should most specifically know about your group before addressing them?
Any inside information or humor Richard should know about?
What will precede Richard?
What will follow Richard?
Who will introduce Richard? (We will provide you with an introduction.)
Would you like a biographical sketch for promotional purposes now?	Yes No
Would you like a 5 x 7 color glossy photograph of Richard?	Yes No
Please list professional speakers you have used recently
Other notes you feel important for Richard to know to make this program your best ever
* Security Code:	Enter the security code to the left.

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