We want to create the perfect presentation for you and your organization. Not like the boring snoozefests that we all experience from time to time, but a dynamic, engaging, downright fun presentation that participants can’t wait to share with long-lost relatives. This questionnaire will help us put together something that will best meet your objectives and wow your crowd. We want to make sure that everything goes as splendidly as possible! Please complete all applicable information. Thanks! Kim and Jason

Client
Appearance Date
Your Name
Title
Birthday (year not necessary)
Phone
Fax
E-Mail
Website
Best time to reach you
The Program
What is the theme of your program? What does it mean to your group?
What type of program is it? (Annual meeting, awards banquet, etc.)
What is the role of the speaker(s) in the program? (Opening or Closing Keynote, Luncheon Speaker, etc.)
What are your specific objectives for this presentation and goals for your audience?
If we were to get together one year after the program, what would have to happen for you to feel that this was the best speaker you’ve ever hired?
Are there any sensitive issues that should be avoided?
What is the exact time frame of this presentation?	From: To:
What time would you suggest for an arrival time?
Where will the program be located?
What takes place immediately before and after the presentation?
Who are the other speakers on the program (if any)?
What professional speakers have you used in the past?
What did you like/dislike about their performance? (List what you remember the most and if you’d like to delete or repeat for your audience.)
Do you have an LCD projector readily available? *Please note: This presentation requires the use of an LCD projector and screen, which should be provided by the host.	Yes No
The Audience
About how many audience members do you anticipate?
Percentage of males/females
Average age of group
Will there be babysitting provided for infants and toddlers? (If no, please know that the intergenerational programs are age-appropriate for ages 5-105.)	Yes No
Is this a specialized group or general public? If specialized, please explain details.
Please list (3) main items you believe we should know before addressing your group:
What are the most significant events that have occurred in your industry, organization, school and/or group this year?
Logistics
What is the nearest major airport to the meeting site?
Distance to meeting site?	Miles: Time:
Do you have any recommendations for a local hotel?
Exactly where is the meeting?	Venue: Address: City: State: ZIP: Meeting Room:
If Kim and Jason have any problems/emergencies on their way to the program, who should they contact?	Name: Phone Number(s):
We thank you for taking the time to fill out this questionnaire. This will help us to plan the best possible presentation for your group. Please contact us if you have any questions or concerns.