Public Speaking:

Note: Use a form similar to this to get the information you need to be great during any public speaking engagement.

These questions are designed to help my staff and I prepare a program specifically suited to the needs of your group. Please take a moment to answer all the questions fully and return the form to my office. We have already answered some of the questions based on our initial conversation. Please double check these answers and make additions and corrections.

We would also appreciate receiving any printed information on your group that may help us with background information (e.g., corporate reports, news items, in-house publications, products, services, employees, etc.). Thank you for your help!

Please return this questionnaire to: 

Presentation Title: Time Frame? Start Time ________ End Time ________ Any breaks? Y N What is on the program just before I speak? __________________________________________________________

What happens on the program right after I speak? __________________________________________________________

Appropriate dress for presentation? __________________________________________________________

Conference title and theme? __________________________________________________________

Specific purpose of this meeting/session (e.g., awards banquet, annual meeting, etc.)? __________________________________________________________

Specific objectives for my presentation? __________________________________________________________

Sensitive issues that should be avoided? __________________________________________________________

Introducer's name?

Introducer's Phone Wk. __________________ Hm. ________________

Is there any publicity work I can help you with while I am at your event? Y N Radio ___ Television ___ Other ___ Type ____________________

Who are the other speakers on the program?

Speaker__________________ Topic _____________________________

Speaker__________________Topic ____________________________

What speakers have you used in the past that covered topics related to the material I will be presenting for you? ____________________________

What did you like and/or dislike? Withhold their names if you like, but do comment on the material they used! _____________________________ __________________________________________________________

Please share any "local color" you may know of relating to the location where my program will be held. _________________________________ __________________________________________________________

Please share any "industry color" related to your organization or industry. __________________________________________________________

What comments or suggestions do you have that will help me make this presentation the best your audience has ever had? __________________ __________________________________________________________


Total number attending? ________ Spouses attending? Y N

Percentage male/female ____________ Average age? _____________

Average annual income ______________

Educational background ______________________________________

Major job responsibilities of audience ____________________________

Will there be any "special guests?" Please explain. __________________ __________________________________________________________

Why is your group attending this meeting (voluntary, mandatory, etc.)? _____________________________________________________

How will they be notified? _____________________________________

What is their overall opinion regarding the subject of my presentation, (favorable, hostile, etc.)? ______________________________________ Please provide the names and positions of three main "movers and shakers" in your organization that will be in the audience, who are well known and well liked. I may joke with them or call on them if the need arises. My staff or I may also want to contact them for more research information on your group (with your permission, of course).

Name ________________________ phone ______________________

Name ________________________ phone ______________________

Name ________________________ phone ______________________


Problems? _________________________________________________

Challenges? ________________________________________________

Breakthroughs? _____________________________________________

What separates your high-performance people from others? __________ __________________________________________________________

Are there any hearing or sight-impaired audience members? Y N

If yes, please provide names and contact information ________________ __________________________________________________________


Problems? __________________________________________________

Challenges? _________________________________________________

Breakthroughs? ______________________________________________


Problems? __________________________________________________

Challenges? _________________________________________________

Breakthroughs? ______________________________________________

Significant events? Mergers? Relocations? ________________________ ___________________________________________________________


Location of presentation and venue name _________________________ ___________________________________________________________

Address _____________________________ Phone _________________

Location at the site ( room-name, etc.) _____________________________

Airport to arrive at ___________________________________________

How will I be transported from the airport to your site? Taxi? _____ Rental Car? _____ Driver? _____

Driver's Name _______________________ Phone _________________

If an emergency occurs on the way to the site, who would be an alternate contact if you are unavailable?

Name ______________________________________________________

Business phone _________________ Home Phone __________________

Thank you for taking the time to provide this information. I will use it to prepare an outstanding presentation for your group.