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Pre-event Questionnaire
Thank you very much for helping Synergy Unlimited to
customize their talk for your group!
- This questionnaire will enable Synergy Unlimited speaker(s); Deborah Deras and/or Adoley Odunton
customize her/their presentation to the exact needs of
your group. Feel free to skip over any answers which
would merely duplicate answers to previous questions or
which might be irrelevant due to the nature of this
event. Your help will increase the value of this program
to your audience.
CONTACTS:
Person filling out this form
Name: __________________ Tel: _____________________
Contact person for day of the event
________________________
Name: __________________ Cell Phone:
_____________________
EVENT INFORMATION:
Day and Date of Event: _____________________
Organization: _____________________
Time: Beginning _________ AM/PM Ending _________ AM/PM
Time you would like speaker(s) to arrive: _________
What is happening before or after our talk?
Will they be serving food during our talk? Yes:___
No:___
Who will arrange for our flipchart and lapel microphone?
Name: ___
Will have time afterward to meet and greet participants?
Yes:_ No:___
Will we have space to autograph books after the program?
Yes:_ No:___
DEMOGRAPHICS:
Number of Attendees: Percentage Male __ Female __
1) Who will attend?
2) What are the main responsibilities of the
participants?
3) What are the demographics of the audience? Age Range
4) Education:_ Cultural Mix: ___
Thank you very much for helping Synergy Unlimited to
customize their talk for your group!
-
PROGRAM CONTENT:
What is the #1 message you hope your group will leave
with after our presentation:
What are the specific objectives for our talk?
Should the message be targeted to one group in
preference to another?
Yes/No if yes, which one? __
What is the life of the audience like during their
day-to-day business?
What frustrations do they experience in their industry
now?
What new trends are happenings in their industry now?
What are the sensitive issues? Are there sensitive
issues that should be avoided?
What is the biggest challenge your company is faced
today?
What is the purpose or mission of your company?
What is the meeting theme or slogan used by your
company?
What industry jargon do you want interjected during the
presentation?
Thank you very much for helping Synergy Unlimited to
customize their talk for your group!
- What other information might be helpful for speaker(s)
to know?
Please suggest two or three speech titles or ideas that
might be compelling to your audience?
How do you want your people to feel when they leave our
presentation(s)?
CUSTOMIZATION: Please list the names of three
accomplished professionals within the group that we can
get an additional perspective from. It would be good to
select people at different levels.
Name:______ Tel:___ Email:___
Name:______ Tel:___ Email:___
Name:______ Tel:___ Email:___
EDUCATIONAL RESOURCES: May Synergy Unlimited
offer educational resources: books, CD’s, and coaching
programs for sale following their program? Yes: ___ No:
___
We will never "hard sell."
PROMOTIONAL MATERIALS: Please send a copy of all
memos, program
announcements, brochures, and other promotional
materials relating to this presentation so our
presentation will be consistent with your promotion. In
addition, any annual reports, a company newsletter /
paper / flyer, or any key product brochures would be
appreciated, if available.
SPEAKER INFORMATION: Please note our biography,
photograph and program descriptions can be found for
your convenience on our website at:
www.synergyunlimited.net
Please fax this form back to our offices at your
earliest convenience at: FAX: 310-945-5652
•
Download a PDF Document of "Pre-Event
Questionnaire" (71 Kb)
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