Questionnaire for the Presentation


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Pre-Program Questionaire

We know you are busy. But we want to help make your event a big success. Please take a few minutes
to fill out as much information as you can. It will allow Rene to really get a good understanding of the
audience in order to deliver a presentation that will resonate with them.

DATE THE MEETING WILL BE HELD

Date of The Presentation:

YOUR COMPANY'S INFORMATION

Company Name:

Contact Name:

Title:

Address:

Phone:

Fax:

Email:

Website URL:

Best time for us to reach you :

MEETING LOCATION INFORMATION:

Meeting Location Name:

Meeting Loaction Address:

Loaction Phone Number:

Event Room:

On Site Contact:

Phone:

Fax:

Email:

Emergency Phone:

HOTEL ACCOMODATIONS FOR RENE

Hotel Name:

Hotel Phone:

Guest Fax Number:

Confirmation Number:

Reservation Date:

TRAVEL INFORMATION FOR RENE

Nearest Airport:

Distance:

minutes

TRANSPORTION:

Client will arrange Rene's office will arrange

Car Service Co:

Confirmation #:

Phone Number:

Pick Up Time:

MEETING LOGISTIC INFORMATION:

AV Company:

Contact Name:

Phone:

Fax:

Email:

PRESENTATION INFORMATION:

What kind of meeting is it?

Start Time:

Duration:

minutes

Is there a function you would like Rene to attend before or after the speech?

Yes No

If yes, what's the function's name?

What company executives speak before Rene?

Please forward transcripts of their speeches for Rene Godefroy
to read and use to tailor his speech if available. ilable.

Appropriate attire: Casual Business Casual Business Formal

Who spoke at this meeting last year?

Will Rene’s presentation be video or audio taped?

Yes No

Is it possible for a guest of Rene’s to attend the presentation:

Yes No

ROOM SET UP

Seating arrangements to be used:

Classroom Theatre Round Tables Square Tables

Will there be alcohol served before or during this presentation:

Yes No

INTRODUCTIONS

Who will introduce Rene?

Title:

Email:

Phone:

Address:

AUDIENCE INFORMATION

Audience Size:

% of Male:

% of Female:

Are spouses invited?

YES NO

Age Range:

Description of attendees:

PERSONALIZATION INFORMATION

Type of event:

Objective of Meeting:

Theme:

Current challenges in your industry:

Who do you consider to be your closest competitions:

Your website address:

How did you decide to hire Rene?

Video Referral Live Presentation Other

What three main things should Rene know about your group?

Is there any jargon Rene should be familiar with (acronyms, titles?)

What are your target markets/industries does your organization primarily focus?

Who is your typical customer or client (eg: C.F.O., V.P. of HR, Purchasing Agent, Attorneys, High Income Individuals, ect..)?

POST PRESENTATION ADDED VALUE

In order to increase the long-term retention of his message, Rene is happy to offer these items. Please check the items below about which you are interested in receiving more information:
	Rene's books, videos, audio tapes/CDs as attendee gifts.
	A book signing/photo opportunity after Rene's presentation.
	Articles written by Rene for your company newsletter.
	Personalized e-mail to your attendees post-presentation.
	Podcast: Audio Messages From Rene to re-inforce his learning points.