Pre-Event Questionnaire

Organization

Primary Contact Name

First Last

Primary Contact Email

Primary Contact Phone

Primary Contact Title

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Preferred Phone Number

Secondary Phone Number (if applicable)

Person Signing Contract (if different from above)

First Last

Contract Signer's Title

Contract Signer's Email

Name of Event

Date

Time

:

Title of Presentation?

Length of Presentation?

What is the theme of the event?

What is the attire for the event?

Any other details you could share?

Expected audience size?

Describe attendee demographic:

What are the key messages you would like this group to take away?

When the presentation is over, what information/feeling/action plan do you want participants to walk away with?

Are there any industry/company/departmental “hot topics” or issues that Simon should be aware of? If so, please describe them here.

Any other details you could share?

Are there any resources you suggest we review prior-to?

Do you plan to record the presentation?

Will you be taking photographs?

On-Site Contact Name:

First Last

Cell Phone:

Type of Presentation (workshop/opening or closing keynote)

Where in the agenda is Simon speaking?

What is the stage set-up?

What is the room set-up?

What time should the speaker arrive on site?

:

Can Simon meet and greet the attendees before the event either in the lobby or inside the room as they walk in?

Are you able to share an attendee list with us?

Anything else you think would be important to know for your event?

Is there anything Simon should avoid while on stage?

Is there anything Simon should include while on stage?

Event Location

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Event Location Phone Number

Nearest airport to event location?

Limo service/other transportation arranged?

Name

This field is for validation purposes and should be left unchanged.

Thank you for your partnership!