PRE-PROGRAM QUESTIONNAIRE

Please print it,
fill it in and fax it to
(952) 896-9784.

Information - (Required items are BOLD)
Organization:	___________________________________________________
Program date(s):	___________________________________________________
Exact time of presentation:	___________________________________________________ (i.e. 8 a.m. to 5 p.m.)
Name of preparer:	___________________________________________________
Position:	___________________________________________________
Phone number:	__________________________________________ext_______
Fax number:	___________________________________________________
E-Mail:	___________________________________________________

Logistics - Transportation

A. What is the exact location of the meeting?

____________________________________________________________________

____________________________________________________________________

Meeting facility:	_________________________________________room#: ______
Mailing address:	_____________________________________________________
Phone number:	_____________________________________________________
Key contact person at hotel:	_____________________________________________________

B. How far is it from the airport to the meeting site?

____________________________________________________________________

C. If the meeting location is different from Thom's hotel accommodations:

Thom's hotel:	_____________________________________________________
Address:	_____________________________________________________
Phone number:	_____________________________________________________
Distance to meeting facility:	_____________________________________________________

D. If any problems or emergencies occur in route to the program,
who should Thom contact? (Please list both numbers)

Name:	______________________________________________________
On-site phone:	______________________________________________________
Home phone:	______________________________________________________

E. Thom will be arriving on (date) ___________________________

at approximately ____________________________________________

via ____________________________________________

F. Thom will be departing on (date) _____________________________________

at approximately ____________________________________________

via ____________________________________________

Lodging

G. Please confirm a hotel room for Thom for the evening(s) of
____________________________________________

Please guarantee these reservations for late arrival and direct bill
the room and tax to your master account.

Program Agenda

A. Thom's presentation:

Start time: _______________________  End time: _________________________

B. What is the name and title of Thom's introducer?

Name: __________________________  Title: ______________________________

C. What will be the appropriate attire at the program?

____________________________________________
 

D. What takes place immediately before and after Thom's presentation (an other speaker, meal function, break, etc.)?

Before: ____________________________________________

After: ____________________________________________

Key Contact List

A. What two people can Thom interview over the telephone to further tailor the event to your needs?

1. - (Required items are BOLD)

Contact Name:	______________________________________________________
Position:	______________________________________________________
Company:	______________________________________________________
Address:	______________________________________________________
Telephone:	______________________________________________________
Fax:	______________________________________________________
E-mail:	______________________________________________________

2. - (Required items are BOLD)

Contact Name:	______________________________________________________
Position:	______________________________________________________
Company:	______________________________________________________
Address:	______________________________________________________
Telephone:	______________________________________________________
Fax:	______________________________________________________
E-mail:	______________________________________________________

B. Officers of the Company / Association (or send a flow chart)

Name:_____________________________	Position:_______________________
E-mail:_____________________________
Name:_____________________________	Position:_______________________
E-mail:_____________________________

C. What State and National Associations do your does the corporation belong to?

Name:______________________________	Position:______________________
Name:_____________________________	Position:______________________

Please include with questionnaire if available:

• Black and white clip art of your logo
• Annual Report (If Available)
• Information to help Thom understand your company or association
• Video about your company or association
• A rough or final agenda of the meeting

Program Contents

A. Conference theme?

________________________________________________________________

________________________________________________________________

B. What is the purpose of this meeting (annual meeting, training, awards, etc.)?

________________________________________________________________

________________________________________________________________
 

C. What are your specific objectives for Thom's presentation?

________________________________________________________________

________________________________________________________________

D. Are there any sensitive issues that should be avoided?

________________________________________________________________

________________________________________________________________
 

E. What behavior changes do you hope will be achieved / what results are you hoping for?

________________________________________________________________

________________________________________________________________
 

F. What other outside speakers will be presenting at this meeting? What are their topics?

Name: _____________________________	Topic: __________________________
Name: _____________________________	Topic: __________________________
Name: _____________________________	Topic: __________________________

G. Which area does this group need the most growth in?

________________________________________________________________

________________________________________________________________
 

H. Most audiences want something to help them continue the learning after the presentation.
What do you prefer?

___ A copy of Thom's book
___ The live cassette album
___ A video recording
___ Other:____________________________________________________________________

Include a mission statement for your organization, if available.

________________________________________________________________

________________________________________________________________

________________________________________________________________

I. What are your people doing right?

________________________________________________________________

________________________________________________________________
 

J. What do you expect from Thom's message: (i.e. motivate, train, reinforce,generate enthusiasm)? List in order of importance.

________________________________________________________________

________________________________________________________________
 

K. Who is most respected among the audience?

________________________________________________________________
 

L. What are the "buzz" words in your industry for this group?

________________________________________________________________
 

M. What seeds, if any, do you want planted?

________________________________________________________________
 

N. What can Thom do that will add a special touch?

________________________________________________________________
 

O. What are the industry / firm trends that are appropriate for Thom to touch on his presentation?

________________________________________________________________
 

Audience Profile

A. What are the major job responsibilities of those in the audience?

________________________________________________________________

________________________________________________________________

B. What three main things do you think we should know about your group before addressing them?

1. ________________________________________________________________

2. ________________________________________________________________

3. ________________________________________________________________

C. Audience:

Number attending? _____	Are spouses invited? ____Yes    ____NO
Percentage of males? ________	Percentage of females? ________
Average age group? ________	Range of age   ________to ________
Annual income (range & average):	range: $ ____________to $_____________ average: $ _________________
Educational background:	___________________________________
How are these people paid? (Salary? Bonus? Commission?)	___________________________________

D. What are the names and proper titles for the following individuals in your organization?

President / CEO	________________________________________
VP of Sales / Marketing	________________________________________
Director of Training / Education	________________________________________
Sales Manager	________________________________________
Meeting Planner	________________________________________

Background
 

A. What is the primary product / service that you offer?

_________________________________________________________________

_________________________________________________________________
 

B. What are the two most important benefits you offer to your customers?

1. _________________________________________________________________

2. _________________________________________________________________
 

C. What are the most common objections received from customers or
prospective customers?

_________________________________________________________________

D. Who are your major competitors in your market areas?

_________________________________________________________________

E. What are your major weaknesses compared to your competitors?

_________________________________________________________________

F. What are your major strengths compared to your competitors?

_________________________________________________________________

G. If you could change your industry (product market), what would you change?

_________________________________________________________________

THANK YOU!