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Pre-Event Customization Questionnaire

Name of Company / School / Organization

Contact Name

Title

What is your role in planning this event?

Address

City

State

Zip Code

Phone Number

Fax Number

E-mail Address

Preferred Speaking Date

Event Name

Presentation Start Time

Desired Length of Program

Address of Event Location

Closest Airport and Distance to Event Location

What are your specific objectives / results desired for this program?

What percentage (%) "How to" / Nuts and Bolts Information?

What percentage (%) Motivational / Inspirational?

What are the demographics of the audience (size of group, position of attendees, background, special interests, etc.)?

What will the participants be interested in learning from this session?

What are the top three challenges faced by the people who will be in the audience?

Is there any special terminology to use in the presentation?

Are there any special issues/terms to not be included in the presentation?

Are there any key people in the audience to be recognized?

Is there a program theme?

How did you become aware of Success By Choice?

Additional Comments