Preprogram Questionnaire
Click below for pdf pre-program questionnaire
Meeting planner friendly PDF pre program questionaire
CHARLES FLEISHER THE OPPORTUNITIES GUY
PRE-PROGRAM QUESTIONNAIRE
Charles Fleisher is looking forward to sharing his programs in order to help you create a successful meeting. His presentation and educational materials will provide you with impact and long term take home value for your attendees. This questionnaire is designed to help us prepare a customized presentation.
Please answer all applicable questions and return to:
Charles Fleisher
621 Shrewsbury Ave., Shrewsbury, NJ07702.
Charles@theopportunitiesguy.com
Fax #732-414-2496
Phone Number 732-895-2610
With the items checked in #19.
ORGANIZATION: _______________________________________________________
Day & Date of Presentation: _______________________________________________
1.
What are your specific objectives/results desired for my session?
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
2.
What is the specific purpose and theme of this meeting (annual meeting, awards,
etc.)
________________________________________________________________
3.
What is the mission/philosophy statement for your company/organization?
_________________________________________________________________
_________________________________________________________________
3a.
Are you announcing any new products, services or other changes at this meeting?
_________________________________________________________________
_________________________________________________________________
4.
What are some current problems/challenges/breakthroughs experienced by your
organization or industry?
Type to enter text
_________________________________________________________________
_________________________________________________________________
5.
What are the top challenges faced by people who will be in the audience?
_________________________________________________________________
_________________________________________________________________
5a.
What do you think they have to do to overcome these things?
_________________________________________________________________
_________________________________________________________________
6.
Has the audience’s business, industry or job changed in the last 5 years? If so,
how?
_________________________________________________________________
_________________________________________________________________
7.
Special jargon/terminology to use? _____________________________________
_________________________________________________________________
Issues/terms to avoid? _______________________________________________
____________
__
____________________________________________________
8.
An executive, manager and/or employee I might contact to get additional
perspective:
Name____________________ Title________________ Telephone #___________
Name____________________ Title________________ Telephone #___________
Name____________________ Title________________ Telephone #___________
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Number of people attending ______________________
10.
Previous speakers used:
Name___________________________ Topic ____________________________
Name___________________________ Topic ____________________________
11.
What takes place immediately before/after my program (speaker, meal break, etc.
If another speaker, please indicate topic)
Before: ___________________________________________________________
After: _____________________________________________________________
12.
Meeting Time: Begin: _______________ End: ________________
My program: Begin: _______________ End: _______________
13.
Name/title of my introducer: ___________________________________________
Name and title of senior executives:
Name _________________________________ Title _______________________
Name _________________________________ Title _______________________
14.
Meeting location:
Address: ___________________________City: _________________________
Hotel/Address Tel. No: _______________________________________________
_________________________________________________________________
Closest Airport (# miles from site): ______________________________________
15.
Top people to recognize in audience:
Name ___________________ Title _______________ Reason _______________
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Name ___________________ Title _______________ Reason _______________
Name ___________________ Title _______________ Reason _______________
16.
How do I get from airport to site? Limo Co. Name: _______________________
Other: ______________________ Phone No.: ____________________________
17.
When, where, who and how should Mitchell contact upon arriving at hotel?
_________________________________________________________________
18.
Emergency Contact? Name: __________________________________________
Bus# _________________________ Home # ____________________________
cell# _________________________
19.
Please send me the following information via link, fax or mail (if available):
___ annual report
___ company newsletter/paper/flyer
___ key product brochures
___ meeting agenda/invitation
___ special promotions/campaigns
NOTES: What can you add which might help us do an even better job?
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
Send completed form to:
Charles Fleisher
621 Shrewsbury Ave., Shrewsbury, NJ07702.
Charles@theopportunitiesguy.com
Fax #732-414-2496
Phone Number 732-895-2610