PRE-EVENT QUESTIONNAIRE
Event Booking Form
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Your event is a: *
If "other", please describe
Name of Organization *
Organizers website, links, social media handles, eventbrite links, etc.
Date of Presentation *
MM
/
DD
/
YYYY
Demographic of Audience *
Anticipated Number of Attendees *
Theme/Topic of Event *
Current problems/challenges/breakthroughs faced by your industry:
List any specific objectives/desired results from my presentation: *
Are there any sensitive issues, terms, gestures to avoid?
When your audience departs this presentation, what ONE takeaway do you want to be pinned on their minds?
What other important points you would like me to address?
How do you most want your audience to feel as a result of my presentation:
Event/Meeting Start Time
Time
:
Event/Meeting End Time
Time
:
My Presentation Start Time
Time
:
Length of my Presentation
Hrs
:
Min
:
Sec
Is Q&A requested after my presentation?
Clear selection
If "Yes" to Q&A, what time will it start and end?
Location *
Site Name / Address / Distance from Airport / Distance from Hotel to Site
Fees and Selling *
Required
Please provide info of what takes place immediately before AND after my presentation (meal, break, etc)?  If another speaker, please indicate speakers’ topic.
(Please note:  I like to arrive one-hour early to each presentation to view the room and set-up as well as personally introduce myself to attendees as they arrive).
If problems/emergencies arise the day of the program, who should we contact
Contact Name & Phone Number
Submit
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