ࡱ> GIF s3bjbj DH<+68,H<"5777777$`!p[[pyyy5y5yy\3~!0,!d!!4>,y$[[d! : Bruce S. Wilkinson, CSP Pre-Presentation Questionnaire We need your assistance. This Pre-Presentation questionnaire has been designed to assist Bruce with the preparation and personalization of his program for your group. ____________________________ Would you please take a few minutes and give us the information we need? We have filled in some of the blanks to the best of our knowledge, but please double-check our information and make any additions and corrections as necessary. Additionally, we would also appreciate receiving any printed background information such as newsletters, marketing material, annual reports, brochures, organizational culture, sales/marketing philosophy, mission, vision, core values, guiding principles, etc. Please return questionnaire to: Julie Bourgeois Wilkinson Seminars and Presentations (a division of Workplace Consultants, Inc.) 350 Emerald Forest Blvd., Ste 24101 Covington, LA 70433 985-249-5234 Fax: 985-249-5235 E-Mail: Bruce@WilkinsonSpeaker .com Please return by: _____________________________ Presentation date: ____________________________ Organization: _____________________________ Presentation title: ________________________________________ Start time:_______________________ End time for Bruce:____________________ Any breaks?_____________________ What is on the program just before Bruce speaks? ________________________________________________________________________________________________________________________________________________ What happens on the program right after Bruce speaks? ________________________________________________________________________________________________________________________________________________ Is there a function the evening before that he may attend to meet attendees? ___________ Meeting Conference/Goals and Professional Concerns What is the purpose and/or theme of this meeting, conference, annual program, awards banquet, training program, etc?) ________________________________________________________________________________________________________________________________________________________________________________________________________________________ ________________________________________________________________________ What are the major goals of this meeting/program? ________________________________________________________________________________________________________________________________________________________________________________________________________________________ ________________________________________________________________________ What is your organizations/associations purpose, philosophy, specialty, market or product? Who is your customer? ________________________________________________________________________________________________________________________________________________________________________________________________________________________ ________________________________________________________________________ What are the biggest challenges/changes facing your industry and/or organization? ________________________________________________________________________________________________________________________________________________________________________________________________________________________ ________________________________________________________________________ What are the biggest challenges/changes facing our audience/attendees? ________________________________________________________________________________________________________________________________________________________________________________________________________________________ ________________________________________________________________________ What are you particularly proud of as an organization, industry, agency or institute? ________________________________________________________________________________________________________________________________________________________________________________________________________________________ ________________________________________________________________________ Are there any major buzz words or technical terms Bruce should be aware of? ________________________________________________________________________________________________________________________________________________________________________________________________________________________ ________________________________________________________________________ Are there any taboo topics, issues or items that Bruce should be aware of? ________________________________________________________________________________________________________________________________________________________________________________________________________________________ Does your organization have an employee assistance program (EAP)? ________________________________________________________________________________________________________________________________________________________________________________________________________________________ Approach to Bruces Presentation What main concept, piece of knowledge or how-to do you want the attendees to retain as the result of this presentation? ________________________________________________________________________________________________________________________________________________________________________________________________________________________ ________________________________________________________________________ How do you want the attendees to feel after hearing Bruce? (I.e., good about themselves, the organization, proud of their work, product, ready for change, etc.) ________________________________________________________________________________________________________________________________________________________________________________________________________________________ ________________________________________________________________________ What action or behavior would you like your attendees to stop, continue or begin as the result of Bruces presentation? ________________________________________________________________________________________________________________________________________________________________________________________________________________________ ________________________________________________________________________ Can you provide a few names of other speakers who have presented at this event? ________________________________________________________________________________________________________________________________________________________________________________________________________________________ ________________________________________________________________________ What did you like or dislike about their style, content or delivery techniques (we do not need names here if you do not want to use them)? ________________________________________________________________________________________________________________________________________________________________________________________________________________________ ________________________________________________________________________ Would you like to provide us with contact information for one or two key people from your group who will be in Bruces audience? Bruce would like to contact them (with your permission) to gather additional information that may be valuable to his presentation and to support desired outcomes. Name:___________________________________________ Position/Title:_____________________________________ Phone:___________________________________________ Email: ___________________________________________ Name:___________________________________________ Position/Title:_____________________________________ Phone:___________________________________________ Email: ___________________________________________ Audience/Organization Profile Estimated # of attendees ____________ Average education ______________ % Female attendees ________________ % Male attendees_______________ Average age and range ______________ Experience level ________________ Will spouses/partners be attending? _______ Titles or positions of people attending ______________________ Dress code for Bruce_________________ ______________________________ (i.e., Business, business casual, etc.) ______________________________ How are attendees paid (hourly, salaried, Bonus, commission?)_________________ __________________________________ % attendees who manages others_________ What is the name and title of Bruces introducer: Name: ____________________________________________ Title: _____________________________________________ Phone: ____________________________________________ Email: ____________________________________________ Please list the most important things Bruce should know about your attendees: __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ Is there anything else Bruce needs to know to be able to present the best program for your organization? ________________________________________________________________________________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________________________________________________________________________________________________________________________________________________________ Travel Information Location of presentation: ___________________________________________________ Address:______________________________ Phone:________________________ No-Smoking room confirmation number:_____________________________________ Phone # and address of hotel if different from location of presentation ________________________________________________________________________ Closest airport to arrive at: __________________________________________________ How will Bruce be transported from the airport to your site? _______________________ Taxi? _____ Contracted? ______ Rental car?______ Pickup person? ___________ Other? ______ Pickup persons name? ____________________ Office Phone? _________________ Home/emergency phone?_____________________ Cell?_________________________ Email: ___________________________________ When possible, please be sure to guarantee Bruces reservations for late arrival and have the confirmation sent directly to our office. Additionally, please arrange for direct billing for room and tax to you and Bruce will pay for incidental charges and bill you later. Thank you for your assistance in this matter. Julie Bourgeois Client Services Manager     PAGE   PAGE \* MERGEFORMAT 5 78 0 x  @ u      . 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