Public Speaking:
PRE-PROGRAM QUESTIONNAIRE
These questions are designed to help my staff and I prepare a program specifically suited to the needs of your group. Please take a moment to answer all the questions fully and return the form to my office. We have already answered some of the questions based on our initial conversation. Please double check these answers and make additions and corrections.
We would also appreciate receiving any printed information on your group that may help us with background information (e.g., corporate reports, news items, in-house publications, products, services, employees, etc.). Thank you for your help!
Please return this questionnaire to: Tom Antion, orders@antion.com cc , tom@ScrewTheCommute.com
Presentation Title:
Time Frame? Start Time ________ End Time ________ Any breaks? Y N What is on the program just before I speak? __________________________________________________________
What happens on the program right after I speak? __________________________________________________________
Appropriate dress for presentation? __________________________________________________________
Conference title and theme? __________________________________________________________
Specific purpose of this meeting/session (e.g., awards banquet, annual meeting, etc.)? __________________________________________________________
Specific objectives for my presentation? __________________________________________________________
Sensitive issues that should be avoided? __________________________________________________________
Introducer's name?
Introducer's Phone Wk. __________________ Hm. ________________
Is there any publicity work I can help you with while I am at your event? Y N Radio ___ Television ___ Other ___ Type ____________________
Who are the other speakers on the program?
Speaker__________________ Topic _____________________________
Speaker__________________Topic ____________________________
What speakers have you used in the past that covered topics related to the material I will be presenting for you? ____________________________
What did you like and/or dislike? Withhold their names if you like, but do comment on the material they used! _______________________________________________________________________________________
Please share any "local color" you may know of relating to the location where my program will be held. _______________________________________________________________________________________
Please share any "industry color" related to your organization or industry. __________________________________________________________
What comments or suggestions do you have that will help me make this presentation the best your audience has ever had? _______________________________________________________________________________________
THE AUDIENCE
Total number attending? ________ Spouses attending? Y N
Percentage male/female ____________ Average age? _____________
Average annual income _______________________
Educational background _______________________________________________________________
Major job responsibilities of audience ____________________________________________________
Will there be any "special guests?" Please explain. ______________________________________________________________________________________
Why is your group attending this meeting (voluntary, mandatory, etc.)? _____________________________________________________
How will they be notified? _____________________________________
What is their overall opinion regarding the subject of my presentation, (favorable, hostile, etc.)? __________________________________________________________________________________
Please provide the names and positions of three main "movers and shakers" in your organization that will be in the audience, who are well known and well liked. I may joke with them or call on them if the need arises. My staff or I may also want to contact them for more research information on your group (with your permission, of course).
Name ________________________ phone ______________________
Name ________________________ phone ______________________
Name ________________________ phone ______________________
DETAILS ABOUT YOUR AUDIENCE
Problems? _________________________________________________
Challenges? ________________________________________________
Breakthroughs? _____________________________________________
What separates your high-performance people from others? ____________________________________________________________________________________
Are there any hearing or sight-impaired audience members? Y N
If yes, please provide names and contact information
__________________________________________________________________________
TELL ME ABOUT YOUR INDUSTRY/PROFESSION
Problems? __________________________________________________
Challenges? _________________________________________________
Breakthroughs? ______________________________________________
TELL ME ABOUT YOUR ORGANIZATION
Problems? __________________________________________________
Challenges? _________________________________________________
Breakthroughs? ______________________________________________
Significant events? Mergers? Relocations? ________________________ ___________________________________________________________
TRAVEL INFORMATION
Location of presentation and venue name
____________________________________________________________________________________
Address _____________________________ Phone _________________
Location at the site ( room-name, etc.) _____________________________
Airport to arrive at ___________________________________________
How will I be transported from the airport to your site? Taxi? _____ Rental Car? _____ Driver? _____
Driver's Name _______________________ Phone _________________
If an emergency occurs on the way to the site, who would be an alternate contact if you are unavailable?
Name ______________________________________________________
Business phone _________________ Home Phone __________________
Thank you for taking the time to provide this information. I will use it to prepare an outstanding presentation for your group.