Contact Information |
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Name of Company / School / Organization |
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Contact Name |
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Title |
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What is your role in planning this event? |
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Address |
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City |
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State |
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Zip |
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Phone Number |
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Fax Number |
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E-mail Address |
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Program Details |
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Preferred Speaking Date |
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Event Name |
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Presentation Start Time |
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Desired Length of Program |
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Will the audience require handouts? |
No
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Address of Event Location |
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Closest Airport and Distance to Event Location |
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Pre-Program Customization |
What are your specific objectives / results desired for this program?
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What percentage (%) "How to" / Nuts and Bolts Information?
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What percentage (%) Motivational / Inspirational?
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What are the demographics of the audience (size of group, position of attendees, background, special interests, etc.)?
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What will the participants be interested in learning from this session?
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What are the top three challenges faced by the people who will be in the audience?
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Is there any special terminology to use in the presentation?
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Are there any special issues/terms to not be included in the presentation?
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Are there any key people in the audience to be recognized?
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Is there a program theme?
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How did you become aware of Empowerment Exchange?
What Audiovisual equipment will you provide?
Will you make copies of materials? If so, how far in advance do you need originals?
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Additional Comments
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