Questionnaire: Kelly Croy: Speaker, Author, and Educator

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Interested in having Kelly Croy speak at your event? Please complete this form. (If you have any questions, email Kelly at Kelly@kellycroy.com, or contact me on my personal cell phone at 419-680-5909 by text or call.) Thank you.

Kelly Croy

Speaker, Author and Educator • www.KellyCroy.com

Contact Person for this event: *

Contact Person's email address *

Contact Person's Phone Number: *

Date of the Event: *

YYYY

Time the Event Starts? *

Time

Name of the Organization? *

Name of the event? (Any websites, hashtags, or online information about the event.) *

What is the purpose of this event? *

Address of venue for event: *

Time Kelly begins: *

Time

Time Kelly is to end his presentation: *

What time can Kelly start setting up? He needs 90 minutes. *

If this presentation could accomplish just one primary goal for your group, what would it be? *

Which type of presentation are you most interested? *

We are interested in Kelly's speaking at our event.

We are interested in both Kelly's artwork.

We would like Kelly to lead a workshop training.

We would like Kelly to lead a virtual training via video chat and screen share.

We would like to consult with Kelly on a issue our organization is facing.

We are interested in hiring Kelly to coach an individual or group on our team.

We are interested in Kelly's books and writing.

Other:

Any special areas you would like Kelly to focus or address? *

What is your budget for a speaker for this event? (Does this include travel expenses?) *

Describe the audience/participants. Any demographics you can share will be helpful. *

Please check any of the following that you will be able to provide: *

Yes, we will provide a sound system for this presentation.

Yes, we will provide an assistant to help Kelly.

Yes, we can provide a video recording of the event. Kelly would LOVE this!

Yes, we can provide photos from the event.

Yes, we can provide a reference letter and testimonial within 14 days after the event.

Required

Looking for maximum impact? Consider including a copy of Kelly's books for every member in the audience to be signed after the event! Bulk orders of books can be ordered at considerable discount when over 25 copies.

Please check any of the following that you are interested in adding to the event: *

We would like to order copies of Kelly's book, Along Came a Leader.

We would like to order Kelly's art prints, customized with our organization's logo and message.

We would like to order copies of Kelly's Children's book, Unthink Before Bed

We would like Kelly to add a breakout session to his keynote.

Required

Please describe the area/location in which the presentation will take place. (Conference room, stage, projector, seating, etc.) *

What is the preferred speaker's attire for this event? (Coat? Tie? Casual?) *

Expected attendance for this event? *

Any previous speakers? Please list and describe. *

Will anyone else be speaking or performing at this event? If so... Who? When? *

What time will Kelly be able to pack up his equipment? It takes him about 30 minutes. He would love to meet audience members, answer questions, etc. too. *

Will this presentation be at the beginning middle or end of the event? *

Will access to WiFi be provided? *

Yes

Will meals be served during the event? If so... Before Kelly? After Kelly? During Kelly's presentation. *

Will travel arrangements be provided? Kelly travels from Ohio. *

We are within reasonable driving distance of Toledo, Ohio.

Hotel will be needed and provided.

Air travel will be needed and provided.

Ground transportation from airport to event will be needed and provided?

Meals will be provided. (Kelly has a seafood allergy.)

Let's talk.

Required

What questions do you have for Kelly? *

Thank you for completing this questionnaire. I look forward to working with you.

If you need any information sent to you, please email me at kelly@kellycroy.com or call my cell phone 419-680-5909. I am a very simple man. I do not need special accommodations or anything like that, but sometimes when you travel from home you do not have access to certain things you need, and that is why some of the questions are included in the information above. Also, I used my name rather than a pronoun for clarity. I do not refer to myself in the third person. Thank you for your help with this.

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