Name*

First Last

Contact Name

First Last

Phone*

Fax Phone

Business Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Email*

Program Title

Name of Event Location

Event Location Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Event Location Phone Number

Closest Airpot

Distance from the Airport

How will Chad be Transported from the Airport

What Hotel will Chad be Staying in?

Hotel Address (if different from event location)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Will this be Charged to Your Master Account?

Yes
No

Brief description of those who will be attending your event

Number of Attendees

Are spouses invited?

Yes
No

Approximate % of males

Approximate % of females

Average age range of audience

What is the theme of your event?

Please provide company mission statement:

Meeting objectives: (What are the three most important things you want to hear your people say as they leave the event)

Please give a brief description of your industry/association.

What are some of the challenges the target audience is currently facing?

Please list job responsibilities of those in the audience.

Are there any sensitive issues Chad should be aware of?

What are some of the accomplishments the audience has attained in the last 12 months?

What are the most significant events that have occured in your industry or organization during the past year? (ie. mergers, cutbacks, relocations, etc.)

Can you provide annual reports, such as progress reports and/or sales results? If “Yes”, please fax them to your Bureau.

Yes
No

What is the primary product/service that you offer?

What differentiates your product/service from that of your competitors?

What are your weaknesses in comparison to your competitors?

What are your strengths in comparison to your competitors?

Please list three major competitors in your industry.

Please list previous speakers that have spoken to this group

What other speakers will be presenting at this same meeting? Please also include their speaking topics.

Who will be introducing Chad? (Please include title / Introduction for Chad will be provided)

What Date does Chad Speak?

What is the appropriate attire for Chad’s presentation?

What time does Chad’s presentation begin?

: HH

MM

What time does Chad’s presentation end?

: HH

MM

What takes place immediately before Chad speaks?

What takes place immediately after Chad speaks?

*Please feel free to send a program agenda to your Bureau.

Who will be Chad’s contact once he arrives? Please give contact #, cell #, emergency #:

Many people like to take something home with them after hearing Chad’s presentation. Available are his book, audio tapes, video tapes, and his “Achieving the Unachievable poster”. Would you like to:

Purchase materials before the meeting at a discounted rate and present to your audience on site. Chad would be happy to sign and personalize his products for your attendees.
Offer materials for purchase at the meeting.
Please don’t offer materials from the platform. We will consider sending them as a follow-up afterward.

Is there any other information that Chad should be aware of prior to the event?

PRE-MEETING QUESTIONNAIRE