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Pre-Program Questionnaire

Contact Information

Full Name*
Title
Email*
Phone Number

Event Info

Company Name
Event Name*
Event Theme*
Event Location*
Number of Attendees*
Keynote or Break-out Session

Keynote Session
Breakout Session
Other
Title of Program
Day, Date & Time of Program
Amount of Speaking Time
Who Will Introduce Sheryl

Transportation / Lodging Information
Hotel Confirmation Number
Will the hotel be billed to your master account?

Yes
No
Emergency Contact Information
Transportation To/From Event

Room Setup
Room # (Location)
What is the stage background and room setup?

Other Program Info
Are there events the night before?

Yes
No
What takes place immediately preceding session: (speaker, meal, workshop)?
Other Speakers/Topics at event: (keynotes, workshops)?
Will audience members be eating during presentation?

Yes
No
What takes place immediately before Sheryl’s program?
What takes place immediately following Sheryl’s program?
Who has spoken in years past?
Audience Info
Audience Member Attire
General Age of Audience
Is the audience primarily men, women or mixed?

Men
Women
Mixed
Describe audience members’ jobs or specialties:
Issues to avoid (if any):
Main ideas to focus on:
Suggestions to make this program even better:
Current challenges in your group:
Most important thing you want your attendees to take away from this presentation:
We are most proud of:
Any inside stories to share:
Job titles of those attending:
Any jargon or catch-phrases for this group I should know?
What are your greatest daily challenges?
Forthcoming changes or challenges?
Is there someone who is always
(fill in the blank with someone who popped in your mind)?
Anything else I need to know to make this an incredible success?
What are the main influencers in morale and attitude in your organization?
Favorite quotations or motivational signs/phrases are the organization
What do you think may be the causes of low morale, negativity (lack of trust, communication, etc.)?
Please provide between 3-5 attendees names/numbers/email addresses that I might get in contact with for customization
(Ideally from top leaders who will be attending this presentation):
Attachment(s)
If you have any attachments, please include them here.
Multiple files should be compressed and uploaded as a zip.
Limit 2 MBs.
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#TheBigBangTheory marathon on #TBS TV 15 hours ago
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