PreProgram Questionaire

Jim’s presentation to your organization can be personalized to the exact needs of your audience by taking a few minutes to answer these questions. The time you spend here can greatly increase the positive impact Jim can make toward your objectives and toward a quality program. You may skip items that are irrelevant to your goals.

Please return this questionnaire to us as soon as possible. The earlier we have this information, the more time Jim has to personalize and fine tune the program for maximum impact. This form can be completed on-line and emailed to us or you may print the form, complete it, and fax or mail it to us.

It is very helpful to have your organization’s supportive, printed information along with this completed questionnaire. You might include, but not limit yourself to: annual reports, product or service brochures, newsletters, or promotional material for this event. If you have a website, please include that information, as well.

Organizational Profile:

Organization Name

Date of Meeting

Meeting Location

Meeting Type

Annual
Sales
Management
Awards

Name of Event

Theme of Event

# Attending

Audience (Please approximate the number of attendees from the following groups)

Executives

Managers

Supervisors

Salespeople

Business Owners

Name of Meeting Planner (or Committee Chairperson)

Phone Number

Fax

Web Address

Company Contact Person

Company President/CE0

SVP of Dept. Responsible for the event

SVP of HR or Training & Development

Associations: Please list a few of your larger member companies

What is the organization's mission? (Feel free to send a mission statement instead.)

Additional Audience Information

Are spouses attending?

yes
no

Average Age

Attendee Age Range

Education Level

Job Titles

What areas or departments will be represented?

Will there be any invited guests or VIPs present? Who?

Is there anything else you feel Jim would need to know about the audience?

Many of the following questions are more appropriate to a corporate, rather than association, program. Feel free to skip any that are not applicable

Has organizational structure been significantly changed in the last year? How?

What are your primary products or services? (Please forward collateral information.)

How is your product or service different from your competitors?

What are the two most important benefits you offer through your product or service?

Describe your competitors. Who are they?

What are the most common objections received from customers or prospective customers?

What are the current, significant trends in your industry?

What national associations does your company belong to?

Please list the organization members (with title and phone number) that Jim would need to speak to prior to your engagement to get a comprehensive view of your organization and its’ needs and objectives.

Name

Title

Phone

Name

Title

Phone

Name

Title

Phone

Please call our office to set appointments for these phone calls if your member requires an appointment for the call or you would like to arrange a conference call for several members at once.

Meeting Profile

Meeting Facility

Full Address

Phone

On-site Contact Person

Name of Event

Specific Objectives for Jim Lorenzen’s presentation

Exact date/time that Jim’s presentation begins

Exact date/time that Jim’s presentation ends

What immediately precedes Jim’s presentation?

What immediately follows Jim’s presentation?

Are there other professional speakers/trainers at this event?

Yes
No

If so, who are they? (PLEASE provide their name, the subject of their presentation, and the time/date of their presentation)

What speaker/trainers have you employed in the recent past?
(PLEASE provide their name, the subject of their presentation, and the time/date of their presentation)

Comments about past speaker presentations

Whew! You’re done! Congratulations.

Your cooperation in providing this information will greatly enhance our service to you and your organization. Thank you for assisting us.

Don’t forget additional information about your product or service that would be helpful.

When this form is received, you will receive an email notification allowing you to forward any additional information to us.

Thanks for choosing James Lorenzen. You can depend on Jim to work closely with to help make this your best event ever!

James Lorenzen Speaker Services

Gardner Hathaway, LLC

11707 Blossomwood Court; Moorpark, Ca. 93021

Secure Mail: PO Box 119; Moorpark, Ca. 93020

805.265.5418

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SPEECH & SEMINAR TOPICS

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