Pre-Event Questionaire

THE MORE CHIP KNOWS ABOUT YOUR EVENT THE MORE SKILL SPECIFIC THE PRESENTATION. (For printable format)    Click Here

This pre-program questionnaire is for Chip's presentation to your group on ______________________________. We need your help! Chip would like to specifically meet your needs with his presentation. Please take a few moments and give us the answers needed. Please send us any printed information on your group that may help us. Corporate report? News publications? Etc.

Return this questionnaire by mail, fax or email to: Chip Morrison, P.O. Box 720455, Atlanta, Georgia 30358, Fax (770)-772-6096, email chip@chipspeaks.com, no later than thirty days prior to the event. If you have any questions please call our office at 770-825-2500 or chip direct at 404-580-9919.

Presentation Title_______________________________________________ Date_______________________________

Time Frame: Start Time____________ End Time ____________ Any Breaks?_________________________________

What is on the program just before Chip speaks?____________________________________ What happens on the program right after he speaks?________________________________________________________________________

What is the appropriate dress code for the presentation?____________________________________________________

Conference Theme?_____________________________________ Specific purpose of this meeting or conference (awards banquet, annual meeting, etc.)_________________________________________________________________________

Specific objectives you want achieved in Chip's presentation?________________________________________________

__________________________________________________________________________________________________

Sensitive issues that should be avoided?__________________________________________________________________________________________________

Introducer's name?_________________________________Phone__________________email______________________

Is there any publicity work Chip can do for you while he is at your event? Radio or television? Please let us know ahead of time, so we can arrange travel._______________________________________________________________________

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 Chip will be presenting to you?______

__________________________________________________________________________________________________

What did you like and/or dislike? Without their names if you would like, but do comment on the material they used._____

__________________________________________________________________________________________________

Name three main movers and shakers of your group that will be in Chip's audience. With your permission, we would like to contact them for more research information on your group.________________________________________________/

Phone____________ / email____________ _____________________________________________________________/

Phone ___________ / email__________________________________________________________________________/

Phone____________ / email__________________________________________________________________________

THE AUDIENCE

Number attending?__________________ % of male to female____________________ Spouses coming?____________

Adverage Age_________________ Income range____________________Adverage Income______________________

Educational Background________________________________ Major job responsibilities of audience______________

_________________________________________________________________________________________________

DETAILS ABOUT YOUR AUDIENCE

Problems?______________________________________ Challenges?_________________________________________

Breakthroughs?__________________________________ What separates your high income, high performance people from the others?____________________________________________________________________________________

TELL US ABOUT YOUR INDUSTRY

Problems?_______________________________________ Challenges?________________________________________

Breakthroughs?____________________________________

TELL US ABOUT YOUR ORGANIZATION

Problems?________________________________________Challenges?_______________________________________

Breakthroughs?____________________________________Significant Events? Mergers, relocations________________

_________________________________________________________________________________________________

Will Chip's presentation be video recorded or taped?__________________ If you wish, Chip will make his educational materials available to your audience, so that they may continue the learning process at home. There are two ways this can be arranged. Please check the one that is most appropriate for your group. A. _____Group purchase in advance for each attendee, at wholesale. B._____ Materials made available at the back of the room after the presentation (at retail prices.)