Pre-Program Questionnaire
Please complete all the applicable information. When you have completed this form, either click on "Submit", print out and fax to (858) 923-2222, or mail to 4370 La Jolla Village Drive, Suite 400, San Diego, CA 92122.
For questions regarding this form, please email info@keithfroehling.com
Appearance Date:
Your Name:
Title:
Phone Number:
Fax Number:
Email Address:
Website:
Best time for our office to reach you:
I. THE PROGRAM
A. What is the theme/topic for your program?
B. What does this theme/topic mean to your organization?
C. What kind of meeting/event is it? (fundraiser, graduation, annual meeting, awards banquet, etc.)
D. What is Keith’s role in the program? (Opening or Closing Keynote, Luncheon Speaker, etc.)
E. What professional speakers have you used in the past?
Speaker:
Topic:
F. What did you specifically like/dislike about their performance? Why?
Like:
Dislike:
II. AUDIENCE ANALYSIS
A. Number attending?
B. Are spouses invited? Yes No
C. Additional Comments:
III. GENERAL BACKGROUND INFORMATION
A. What three main things should Keith know about your group? 1.
2. 3.
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