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Event Questionnaire
Managing Change, LLC
27 Dearborn Avenue, Unit 432, Browns Mills, NJ 08015
Office: 609-556-9816 Cell: 609-247-2799 Email: Ronald@ManagingChnage2.com
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* Indicates required question
Full Name:
Your answer
Company:
Your answer
Mailing Address
Your answer
City
Your answer
State/Province
Your answer
Zip / Postal Code
Your answer
Mobile Number
Your answer
Office Number
Your answer
Alternative Number
Your answer
Fax Number
Your answer
Email
*
Your answer
Web Address
*
Your answer
Theme of Program
Your answer
Date of Event
Option 1
Option 2
Option 3
Other:
Clear selection
Meeting Type
Your answer
Who is responsible for the event, (sales, legal, marketing, QC, etc)?
Your answer
Contact information for this person or committee
Your answer
Best time for me to conduct a test of equipment and connections before the event?
Your answer
Discribe my role in the program (opening, mid-point, closing, luncheon etc)
Your answer
What company stakeholders will be present
Your answer
What transportation will be used to and from the airport, to and from the hotel and to and from the venue if applicable?
Your answer
Who is the contact department and/or person for audio/video crew, if applicable?
Your answer
Who are the people in your organization responsible for the following?
Choose
President/Executive Director, email address
V.P. of Sales/Marketing, email address
V.P. of Operations, email address
V.P. of Administrations, email address
Who makes the following decisions for supportive programming?
Your answer
Would you like to discuss investing in appropriate attendee books, tapes and videos from Ronald?
Books
Tapes
Videos
Other medium of your choice
Other:
Would you like to discuss a level of coaching support for after the event from Ronald?
Yes for now
Yes within 90 days
Maybe at a later time
Not at this time
Other option of your choice
Other:
Clear selection
Would you like to discuss one-on-one or group training and support for after the event from Ronald?
Yes for now
Yes within 90 days
Maybe at a later time
Not at this time
Other option of your choice
Other:
Clear selection
Would you be interested in utilizing Ronald's web-based courses, webinars and or online bespoke programs for your associates and employees?
Choose
Yes we would, now
Yes within the next 90 days
Perhaps at a later time to discuss
Not at thsi time
Other option of your choice
What are the primary concerns for the success of this event?
Your answer
What would you like to accomplish by having Ronald speak with your people?
Your answer
What will be the make up of the audience? Male to female. Young entry level to senior executives. Any specific department that will be in attendance?
Your answer
What changes are currently going on or pending that I need to be aware of to speak earnestly with your people?
Your answer
What keeps senior management awake at night?
Your answer
What are the sensitive topics or issues that should not be addressed at this event?
Your answer
Can I interview a few of your associates to gain a better understanding of the pulse of your company?
Your answer
In case of Emergency or travel delays who should I contact?
Your answer
Will this event be published on the companyintra media platform? If so will you allow me to reuse the publication, video or audio files on my social media real estate?
Your answer
I would like to obtain any organizational newsletters, publications or press releases, trade magazines or chronicles to do my homework in making sure this event is a success?
Your answer
Any comments, direction, comments from taking this questionnaire that will help to make our event a success?
Your answer
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