It is important that your speaker receive as much information as possible prior to your event in order to prepare the best possible presentation for your organization.
Please complete this form and return it to our office as soon as possible.
General Information
Speaker
Program Date
Organization
Person completing form
Phone
Fax
Email
Program Start Time
Program End Time
Topic
Event Location
Address
Room
Type of Event (Annual Meeting, Awards Banquet, etc.)
Event Theme
What takes place immediately before your speaker's program?
What takes place immediately following your speaker's program?
Speaker's role in program (opening or closing keynote, luncheon speaker, etc.)
Name and title of introducer
Appropriate attire for speaker
Person providing audiovisual requirements and setup
Work Phone
Cell Phone
Title
Email
What time will the room be available for equipment check or rehearsal?
Who spoke at this event last year?
Who else is speaking at this event?
Any other functions (meals, etc.) speaker is required to or invited to attend?
Ground Transportation - airport to hotel, hotel to event site (check all that apply)
Speaker will be met at airport by
a limo service
If yes, name of service
Phone
Where will driver meet speaker?
Speaker will be met at airport by a member of your organization
If yes, name of individual
Phone
Where will individual meet speaker?
Speaker will be transported from hotel to event site by a member of your organization
If yes, name of individual
Phone
Where will individual meet speaker?
Speaker will take a taxi
Speaker will rent a car
Participant Profile
Total Number Attending
% Men % Women
Average Age
Will spouses be in attendance?
Job Titles
Names and titles of any executives or VIPs your speaker should be familiar with
Name
Title
Name
Title
Name
Title
Organization Overview
Please provide a brief description/profile of your organization
What is your organization's mission statement?
Please list the names of people who would be in a position to provide pre-program input to your speaker regarding issues such as company style, needs, goals, etc.
Name/Title
Phone
Name/Title
Phone
Name/Title
Phone
What is your organization's website address?
Current challenges/problems in your industry
What are the top challenges faced by the individuals who will be in attendance?
What changes have taken place in your organization/industry in the last few years?
What changes do you anticipate in your organization/industry in the near future?
Who are your biggest competitors?
Jargon your speaker should be familiar with
What do you most want this group to get out of this event?
What would make this session exceed your expectations?
What are your major objectives for this event?
Are there any sensitive topics that should be avoided?
If your speaker could leave your group with two thoughts, what would they be?
1.
2.
Why did you choose this speaker for your event?
Is there anything further your organization requires from the speaker or Picture Perfect Speaker, Inc. at this point? If yes, please comment here:
Yes No
Thank you for choosing Picture Perfect Speaker, Inc.
