Company Name: 

Website Address:

Speakers Contacts:

Contact prior to the event:

Title:

Phone (work):

Phone (cell):

E-mail:

Contact at the event:

Title:

Phone (work):

Phone (cell):

E-mail:

The Event:

Where will the event take place:

What type of event will it be:

(Annual Meeting, Awards Banquet, Incentive, etc)

What is the TITLE or THEME:

My presentation will begin at:

My presentation will end at:

Who will introduce me:

What will take place immediately before my presentation:

What will take place immediately after my presentation:

What is the overall objective of your meeting:

The Audience:

How many people will be in the audience:

What % Men:

What % Women:

What is the average age:

Who will they be:

(CEO's, VP's, Sales Reps, Customers, etc)

What will the be wearing:

Will spouses be attending:

Names and Titles of any executives or VIP's I should be familiar with:

Who will be the most senior company official at the event:

My Program Content:

What speech title have you selected:

What are your specific objectives for my session:

What are some positives aspects of your organization:

What are the major challenges facing the audience:

Are there sensitive topics I should avoid:

Any "Taboos" to avoid:

What are some BUZZ words your people will identify with:

Ideas you would like me to emphasize:

As a result of this presentation, what would you like to achieve:

Logistical Information:

Hotel Accommodations:

Confirmation Number:

Closest airport to Hotel:

Distance from airport:

How did you learn about my presentation?

Who referred you to me: