Body Language Expert  

Motivational/Keynote Speaker & Media Personality
www.carolynfinch.com

Pre-program Questionnaire

The following questionnaire will greatly assist Ms Finch in preparing for your meeting. Any collateral materials (i.e. brochure, promotional video, annual report, etc.) on your company and/or group for Ms Finch's review would also be of great value.

Please complete all applicable information.
For questions regarding this form please call our offices at (800) 864-1022 and ask for Angela Stone.
Print, Complete and Fax this form to: (203) 743-5675
Or, Mail to: Electrific Solutions, Inc.
51 Cedar Drive
Danbury, CT  06811
E-mail to:  carolynf@electrific.com

Client:
Appearance Date:
Please complete and return by:
Your Name:
Title:
Company/Organization:
Phone Number:
Fax number:
E-mail address:
Web site:
Best time for our office to reach you:

I. THE PROGRAM

A. What is your program THEME?
B. What does this theme mean to your group?
C. What kind of meeting is it? (annual meeting, awards banquet, etc.)
D. What are your specific objectives for Ms. Finch's presentation?
E. Are there any sensitive issues that should be avoided?
F. Who is responsible for calling this meeting? (HR, Sales, Marketing, etc.)
Name:
Title:
G. What is the name and title of Ms Finch's introducer?
Name:
Title:
H. Exact times of Ms Finch's presentation? (Please attach program agenda)
Starting:	Ending:
I. There will / will not be a coffee break.
Approximate time:
J. What is Ms Finch's role in the program? (Opening or Closing Keynote, Luncheon Speaker, etc.)
K. Which company executives, association board and/or industry experts will be speaking at this meeting?
Speaker:
Topic:
Day:
Speaker:
Topic:
Day:
L. Who are the other professional speakers on this program?
Speaker:
Topic:
Day:
Speaker:
Topic:
Day:
M. What professional speakers have you used in the past?
Speaker:
Topic:
Speaker:
Topic:
Speaker:
Topic:
N. What did you specifically like/dislike about their performance? Why?
Like:
Dislike:

II. AUDIENCE ANALYSIS

A. Audience:
Number attending?
Are spouses invited?	Yes   No
Average age of group?
Job titles:
B. Toward which group should Ms Finch primarily direct her presentation?
C. Who are the people within your organization responsible for the following:
President/Exec. Director:
Name
Exact Title
Phone number
V.P. of Sales/Marketing
Name
Exact Title
Phone number
Sales Training Manager:
Name
Exact Title
Phone number

III. GENERAL BACKGROUND INFORMATION

A. What three main things should Ms Finch know about your group?
1.
2.
3.
B. On which target markets/industries does your organization primarily focus?
C. Who is your typical customer (e.g.: CFO, VP of HR, Purchasing Agent, Consumer)?
D. What is the primary product/service that you offer?
E. Who are your major competitors?
F. Any additional comments or information that would be helpful in tailoring this presentation for your group?

IV. LOGISTICAL INFORMATION

A. What is the nearest major airport to the meeting site?
Distance to meeting site?	Miles: Time:
B. For transportation from the airport to the meeting site would you prefer:
To have Ms Finch met at the airport?
Where?
By who?
Emergency #
To have Ms Finch take a cab?
Approximate cost?
C. Exactly where is the meeting?
Venue:
Address:
City:
State:
Zip:
Phone:
FAX:
Meeting Room:
D. Hotel Ms. Finch will be staying:
Address:
City:
State:
Zip:
Phone:
FAX:
*** Confirmation # for Ms. Finch's room reservation:
E. If Ms. Finch has any problems/emergencies on her way to the program, who should she contact?
Name:
Business Phone:
Home Phone:
Cell Phone:
F. Ms Finch typically dresses in formal business attire. Should you have a special request (i.e. western or luau theme, etc.) please address here: