Download this page as a PDF
PRE-PROGRAM QUESTIONNAIRE
This questionnaire is designed to help us prepare a program that is specifically tailored to the needs of your group. Please take a moment to fully answer all the questions, and return the form to our office. Thank You!
1. AUDIENCE ANAYLSIS INFORMATION:
a. Number of attendees? __________ Spouses Invited? _________________
b. Number of males? _____________ Females? ______________________
c. Average Age of group? __________Range of Age? _________ to ________
d. Major responsibilities of audience members? ________________________
__________________________________________________________
e. What are the names/titles of your top people who will be at the meeting?
__________________________________________________________
__________________________________________________________
2. THE PROGRAM ITSELF:
a. What is your specific objective for my session? ______________________
__________________________________________________________
b. Are there issues/topics you think I should discuss during the program? __________________________________________________________
__________________________________________________________
c. Key issues to avoid (if any)? ____________________________________
__________________________________________________________
d. Name and Title of my introducer: _______________________________
e. Starting times for My program ___________ Entire program __________
f. Ending times for My program ____________ Entire program___________
g. What takes place before my program (speaker, meal, workshop)? __________________________________________________________
h. What takes place immediately after my program (break/another speaker, etc.)? __________________________________________________________
i. If other speakers are presenting, who are they and what are their topics? __________________________________________________________
j. Do you have any other suggestions to make this program your best ever?
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
3. GENERAL BACKGROUND INFORMATION:
a. What do you consider the primary strengths of your organization/people? __________________________________________________________
__________________________________________________________
b. What are some of the current problems in your industry/ organization/ people? _________________________________________________________
_________________________________________________________
c. What areas of their overall working performance are ripest for improvement? _________________________________________________________
_________________________________________________________
d. What are the most significant events to have occurred in your industry or organization or group during the past year? _________________________________________________________
e. What are the top three challenges faced by the people in my audience? __________________________________________________________
f. Please share with me any “industry color” (I.e., promotions, unusual regulations
or policies, Murphy’s Law in action, etc.)._____________________________
___________________________________________________________
g. When people depart from this presentation, what one thing do you want to be uppermost in their minds? _______________________________________
___________________________________________________________
___________________________________________________________
h. Any other suggestions? ________________________________________
___________________________________________________________
