Pre-Program Questionnaire

Please help us tailor your program by answering the questions below. Complete as many as are relevant; you may skip any. Everything you share is confidential and will not be shared with any third party by any means or medium.

Pre-Program Questionnaire
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Section A — Intro & Consent

Confidentiality: All information provided is confidential and will not be shared with any third party by any means or medium.

Please answer as fully as is relevant. You may skip any question. This helps us tailor your program precisely to your audience.

Section B — Event Basics

Venue Address
Venue Address
City
State/Province
Zip/Postal
Country
Organization Address
Organization Address
City
State/Province
Zip/Postal
Country
Is there an intermediary contact person?
Intermediate Contact (if booked through an intermediate company or speaker’s bureau)

Section C — Program Timing

Purpose, overarching theme, outcomes
e.g., $5,000–$8,000 or Max $7,500

Events Date (s)

Add as many start and end dates as required.
My Segment Start Time
When should my segment begin?
How much time do I have?

Section D — Audience Profile

e.g., 22–65
Sex Distribution
Is attendance mandatory for the meeting?
Is attendance mandatory for my presentation?
Will there be many people who are different from the description in the previous question? If so, how are they different?

Section E — Context & Challenges

What should I know about the people in your group before I start my presentation? Are there any problems, competition, resentment or peer pressure that I should know about?

Section F — Past & Other Speakers

What other professional speakers will be presenting at this meeting? What will they speak on? Are they speaking before or after my presentation?

Past Speakers Used

Add as many past professional speakers you have used in the past that you can remember.
Order vs. my session

Other Speakers at This Meeting

Add the other professional speakers speaking at this meeting.

Section G — Personalization & Key People

People I may playfully reference (if appropriate)

Add all those I can playfully reference.

People I should recognize (if appropriate)

List the names and titles of your TOP people who will be at my presentation?

Section H — Objectives & Outcomes

Are there any particular topics or issues that I should address during my program? Are there any sensitive issues that I should avoid?

Section I — Travel/Escalation & Introducer

Who will be introducing me?
Note anything I should know about the introducer
How should we handle post-program learning materials?
Delivery Timing (Group)
Individual Purchase Options

Maximum file size: 5MB

Please upload your organization’s logo (or event logo) so that I can personalize my materials for your group.

Section J — Post-Program Learning

Maximum file size: 5MB

Please upload any material (newsletters, brochures, annual reports, interesting trends, etc.) in your group or industry - This will help me customize my presentation.
Share typical ballroom/classroom temp (°F/°C), any fluctuation, stage lighting heat, and any attire policies on stage.
Stage Lighting Heat
Room Characteristics

Section K — Uploads & Brand Assets

Furniture on Stage
List all available inputs/outputs and adapters provided.
Audio Inputs Available to Speaker Device
Microphones Provided

Section L1 — Logistics Venue Environment

Video Inputs at House Display/Switcher
Adapters Available On-Site
Confidence/Return Monitor on Stage
Power Near Stage

Section L2 — Logistics - Audio & Video Connectivity

Internet for Presenter

Section L3 — Logistics - Power & Internet

Accessibility & Access Notes

Section L4 — Logistics - Load-In, Access & Timing

Will the session be recorded or live-streamed?
Who owns the recording? Can clips be used for the speaker’s reel? Delivery format/ETA?
Photo/Video Policy
Will materials or merchandise be shipped?
Attention to Name
Attention to Name
First Name
Last Name

Section L5 — Logistics - Recording, Streaming & Media Rights

Address
Address
City
State/Province
Zip/Postal
Country

Section L6 — Materials, Shipping & Merch

Maximum file size: 134.22MB

Section L7 — Logistics - On-Site Schedule & Holds

Section L8 — Logistics - Contacts & Approvals

Approvals to acquire

Approvals Required
Thank you for helping us prepare a high-quality, tailored program. You’ll receive a confirmation email with a copy of your responses.

Section L9 — Logistics - Risk & Contingencies

Section M — Final Confirm & Submit

Use Shift+Tab to go back

All information provided is confidential and will not be shared with any third party by any means or mediums. Data is stored securely for engagement planning and service delivery.

This Pre-Program questionnaire is the OFFICIAL PROPERTY of Joseph L. Follette, Jr. M.Div. LMFT

www.JoeFolletteSpeaks.com

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