Presentation title ____________________________________________
Date _______________ Start time ________________
End time ____________ Breaks? __________________
What is on the program just before Bill speaks? ____________________
Will Bill be able to have some staging set-up time right before
he speaks? ______
If Bill goes on right after another speaker, or with no staging
set-up time due to program restrictions, when can he arrive
to set up his staging area? ___________________
What happens on the program right after he speaks? ____________________
When does your meeting begin? (date and time) _______________
When does it end? (date and time) ____________
Audience dress code for the meeting: __________
Do you want Bill to write an article for your newsletter or
other publications prior to his program? ______
Your desired program mix:
____% Motivation
____% How To/Nuts & Bolts
Conference/meeting theme ________________________
Specific purpose of this meeting (awards banquet, annual meeting
etc.) ________________________________
What is the theme of this specific meeting? __________________________
What are you hoping to accomplish with this meeting? ________________________
Why do you think I'll be an asset to this meeting? __________________________
What are you hoping to accomplish with my particular program?
__________________________
How will you know if my program is successful? Give me a target.
__________________________
Are there any particular topics or ideas that I should address
during my program? __________________________
Are there any sensitive issues that should be avoided? __________________________
What is the audience's overall opinion regarding the subject
of my presentation? (favorable, hostile, neutral?) ______________
Please list some industry-specific terms, phrases, jargon
or acronyms that I might incorporate into my program.
__________________________________________________
Please list any humorous buzz-words, pet peeves or inside
jokes in your industry or organization I might use for humorous
material. ________________________________________________
Please share any "local color" (humorous goings-on) you may
be aware of relating to the location where my program will
be held. ________________________________________________
Introducer's name and title: ________________________________________________
Work Phone ________________ Meeting-site
phone ________________
E-mail ____________________________________________
Would this person, or another person, be able to assist Bill
just before his program ends in collecting program evaluations
in return for a raffling of a valuable prize? ______
Is there any publicity work Bill can do for you while he is
at your event? Radio or television? Please let us know ahead
of time, so we can arrange travel. ___________________________
Who are the other speakers on the program?
Speaker _______________________________
Topic ________________________________________________
Speaker _______________________________
Topic ________________________________________________
Speaker _______________________________
Topic ________________________________________________
What speakers have you used in the past who covered topics
related to the material Bill will be presenting to you?
_______________________________________________________________________
What professional speakers have you used in the past and what
did they speak on?
_______________________________________________________________________
What did you like and/or dislike? Without their names if you
would like, but do comment on the material they used.
_______________________________________________________________________
Name three main movers and shakers of your group that will
be in Bill's audience. With your permission we would like
to contact them for more information on your group.
Name __________________________
Phone ________________
Name __________________________
Phone ________________
Name __________________________
Phone ________________
What would make Bill's presentation really "special" for your
group? _______________________________________
THE AUDIENCE DEMOGRAPHICS
Number attending:
____% Female
____% Male
____% of Guests
Spouses attending? _________
Average age of attendees: _________
Annual average income: _________
Income range: _________________________
Educational background:
____ % Ph.D./Masters
____ % College Grad
____ % HS. Grad
Major job responsibilities of audience:
____ % Senior executives:
____ % Board of directors
____ % Admin./clerical
____ % Mid-management
____ % Officers/sales reps
____ % Entrepreneurs
Ethnic diversity:
____ % Caucasian
____ % Hispanic
____ % Asian
____ % Black
____ % Other
Positions/Job Titles __________________________________________
DETAILS ABOUT YOUR AUDIENCE
Is their attendance at your meeting mandatory? _____
Is their attendance at my program mandatory? _____
Please describe what the audience will be doing in the hour
preceding my program. _________________________________
What will they be doing after my program? ______________________________
What should I know about the people in your group before I
start my program? Are their any problems, competition, resentment
or peer pressure that I should be aware of? ______________________________
Their challenges: ______________________________
Their breakthroughs: ______________________________
What are the most significant things on their minds as they
come to this meeting? ________________________________________
Are there any hearing or sight-impaired individuals who will
attend my program? ________
What separates your high performance people from others? ___________________________________
TELL US ABOUT YOUR INDUSTRY
Problems: __________________________
Challenges: __________________________
Breakthroughs: __________________________
TELL US ABOUT YOUR ORGANIZATION
Problems: __________________________
Challenges: __________________________
Breakthroughs: __________________________
What are the greatest accomplishments of this group? __________________________________
What are the current projects of this group? ______________________________________________
Significant events? __________________________________
Mergers? __________________________________
Relocations? __________________________________
Will Bill's presentation be audiotaped and/or videotaped?
______________
EDUCATIONAL MATERIALS
If you wish, Bill will make his educational materials available
to your audience, so that they may continue the learning process
at home. There are two ways this can be arranged. Please check
the one that is most appropriate for your group.
A. ____ Group purchase in advance for each
attendee, at wholesale.
____
Deliver before the program
____
Deliver at the end of the program
B. ____ Materials made available at the
back of the room after the presentation.
If you checked "B", please make sure that:
1. Nothing will be on the program directly
after Bill's presentation and that there will be a break for
at least 20 minutes.
2. A table will be made available for Bill
to place his materials by the exit door.
3. Someone from your group will assist with
sales.
We can provide free articles for your web site, e-zine or
hard-copy newsletter. What topics would you like?
_____________________________________________________________________________
(For an overview, see our web site, MentalGameCoach.com).
What deadlines do you have for inclusion of these articles?
On the web site: _________________________
For your e-zine: _________________________
For your hard-copy publications: _________________________
TRAVEL INFORMATION
Location of presentation and venue name ____________________________________
What time can we get into the room to set up? ________________________________
Who would the contact person be to allow us entry?
Name: ______________________________________
Address: ____________________________________
Phone: _____________________________________
Location at the site itself: __________________________
Airport to arrive at: _______________________
How will Bill be transported from the airport to your site?
____Taxi
____Rental car
____Pick-up person?
Pick-up person's name: ________________________ Phone
_____________
If an emergency occurs on the way to the site, who would be
an alternate contact if you are unavailable?
Name and title ________________________________________________
Business phone _____________ Home phone
_____________
On-site phone _____________Pager _____________
What is your organization's WEB SITE address?
What is YOUR e-mail address? ______________________________________________
Your name and title ________________________________________________________
Your direct phone ______________________________________________________
Thank you very much for your help in making our presentation
a success!! We are looking forward to working with you closely
to make sure everyone has a good time and leaves the program
with valuable information.
Bill Cole, MS MA
CEO
Procoach Systems
|
