Pre-Event Questionnaire


Your Name:

Your Email:

Event Title:

Organization:

Event Date:

Event Time:

Attire:

The Program

What is the conference/meeting theme?


What is the specific purpose of this meeting? (Annual event, Awards Banquet, etc. and which year?)


What are your specific objectives for this event?
   1)   
   2)   
   3)   

What takes place immediately before and after Amanda’s presentation (lunch, another speaker, etc.)?
   Before    
   After    

Who will introduce Amanda?
Title:

Time of Presentation:
Start:
End:

Length of Q & A (If any) (Included in above times)

Are you planning to audio and/or video tape the presentation?
Audio?
Video?

What will the tapes be used for?

Please remember, you must received written permission from Amanda to record a presentation.

Are you requesting permission now or have you already done so?

Which speakers have you used in the past for a similar event?

With your permission, we would like two contact persons Amanda can personally speak to for more information.

Contact #1:
Name:  
Title:  
Phone (W):  
Phone (H):  
Phone (C):  

Contact #2:
Name:  
Title:  
Phone (W):  
Phone (H):  
Phone (C):  

Is the event       Private or     open to the public?

Audience Information

Number of attendees:  

Are spouses invited?       Yes    No

Percentage male/female:  

Average age:  

Ethnic make-up:  

Who will be attending this event (executives, managers, employees, clients, community, etc.)


What are the names and titles of your top executives who will be at the meeting?
   1)   
   2)   
   3)   

Is there anything Amanda should know about the audience before addressing them?


General Background Information

What is the purpose/mission of your organization?


Is there a shared concern by the audience and, if so, what is it?


What is the greatest challenge they are currently facing?


What are the most significant events that have occurred in your industry, organization or group during the past year?


Additional Information

Contact Person at the event:

Phone Numbers:
   Work)   
   Home)   
   Cell)   

If there is an emergency during traveling, who should be contacted?
Name:

Phone Numbers:
   Work)   
   Home)   
   Cell)   

Event location:

Phone:
Fax:
Event room:
Distance from hotel:
Distance from airport:

Audio/visual requirements confirmed:

Amanda requires a wireless lavalier microphone, a PowerPoint projector, screen, and a PowerPoint remote control. Click here for audiovisual requirements.

Have these arrangements been made?                 Yes     No

Hotel where Amanda will be staying. Room should be a wheelchair accessible, double-occupancy, non-smoking, king or queen-sized room (for lodging requirements click here), charged to the master account for room and tax, and a regular room for assistant, if required.

Hotel Location:

Phone:
Fax:
Distance from airport:
Confirmation number:

Person picking up and returning Amanda to airport (if required):
Company:
Name:
Phone:
Cell:

Where will the driver meet Amanda?
                At the baggage claim     Curbside

Driver needs to have a sign that says
“BOXTEL.”

      Why Amanda?
      Initial Booking             Request
      Fee Request
      Pre-event             Questionnaire
      Contract Download
      Contact Amanda
© 2005 Amanda Boxtel - All Rights Reserved