Your Name *

Your Title *

Company Name *

Email *

Phone

Cell Phone Number (for texting) *

Street Address *

City, State *

Zip

Event Date & Name of Kim's Program? *

Event Location?

What's the conference theme or focus?

Number of Attendees?

Contact name on-site at the event?

Who will introduce Kim?

Intro will be sent

Event/Organization Hashtag?

Are there any events the night before Kim speaks?

What takes place immediately prior to Kim’s session? (speaker, meal, workshop)

Other speakers/topics at event?

Will audience members be eating during Kim’s session?

What takes place immediately following Kim’s session?

What speakers have you had in the past who were a hit? What made that experience successful? Have there been any who did not go over well (and if so-- what made that happen)?

Audience Age Range?

Demographics: % of men: % of women:

What would you like your audience to do differently as a result of Kim’s presentation?

What will be their mood? Did they just get any good news, or bad news?

Are there a pending change Kim needs to be aware of?

Describe your attendees professional level... (Check all that apply)

Will spouses be attending the event? If so will they be encouraged to attend Kim’s presentation?

Yes

No

Maybe

Describe your attendees' job(s)... What do they do every day?

What causes them to go into EMERGENCY MODE- where they have to deviate from that day to day routine because of unexpected changes? And provide a specific example of the something recent that happened (that could be mentioned with humor- so not too "raw" for your attendees)?

Who is your organization's target market?

What is the greatest challenge your attendees are facing which you would like addressed?

Are there any industry issues Kim needs to be aware of?

Any additional information about the audience you want to share?

What is of importance to your attendee experience? (Check all that apply)

Check all the areas you would like Kim to integrate in her presentation

LANGUAGE: What does your organization call your "upline" Leaders? Boss? Managers? Supervisors? Team Leaders? Project Leaders? Something else? (Kim wants to use YOUR language)

LANGUAGE: What does your organization call your Internal Customers-Team? Co-workers? Projects? Group? Department? Cross-Functional Team? (Kim wants to use YOUR language)

LANGUAGE: What does your organization call your End User- Customer? Client? Consumer? Member? (Kim wants to use YOUR language)

What else does Kim need to know?

Pre-Program Questionnaire

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