Contact Information
Client Name:
Contact Name:
Telephone #:
Fax #:
Business Street Address:
City, State, Zip:
Email Address:
Web Address:
Event Information:
Program Title:
Dates of Convention/Event:
Name of Event Location:
Event Location Address:
Event Location Telephone #:
Distance from the Airport:
Doug’s ground transportation:
What hotel will Doug be staying in?
Hotel address if different from event location:
Will this be charged to your master account?
(If “Yes”, please provide confirmation #)
Who will be Doug’s contact once he arrives?
Please give contact #, cell #, and emergency #:
What other speakers will be presenting at this same meeting? Please include their speaking topics?
What date does Doug speak?
Who will be introducing Doug?
What is the appropriate attire for Doug’s presentation?
What time does Doug’s presentation begin?
What time does Doug’s presentation end?
What takes place immediately before Doug speaks?
What takes place immediately after Doug speaks?
Audience and Organization Information
Brief description of those who will be attending your event:
Approximate # of attendees:
Are spouses invited?
Approximate % of Males:
Approximate % of females:
Average age of audience:
Age range in audience:
What is the theme of your event?
What is the purpose of this meeting? Annual convention, training, sales, seminar, etc.
Please provide company mission statement:
Meeting objectives: (What are the three most important things you want to hear people say as they leave the event?)
Please give a brief description of your industry/association.
What are some of the challenges/changes the target audience is currently facing?
Please list job responsibilities of those in the audience.
Are there any sensitive issues Doug 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 occurred in your industry or organization during the past year? (i.e. mergers, cutbacks, relocations, etc.)
What is the primary product/service that you offer?
Who are your biggest competitors and what differentiates your product/service from that of your competitors?
Connecting to the Human Spirit
Please provide some interesting funny stories, accomplishments, and or unique hobbies about specific members of the audience?
What are your people talking about? What’s on their mind? What are the hot topics?
What are the inside jokes in the industry/organization?
What are the names of new projects, phrases, acronyms, jargon etc?
What are some of the group’s favorite things to do, or places to go, places to eat, etc?
What is unique about your group?
Who are the “go to” people?
Please give some quotes or phrases used by leaders in the organization?
Please give the names of 5 people who could be fun to use for object lessons?
Product Information
Many people like to take something home with them after hearing Doug’s presentation. Available are his book, music CD and poster “Take Life by the Helm”. Would you like to:
Is there any other information that Doug should be aware of prior to the event?
Follow Up
If you enjoy the presentation would you be willing to provide Doug a letter of recommendation?
Would you be willing to give a reference that might be interested in Doug’s message?
