Pre-Program Questionnaire to book Mary Miscisin

Pre-Program Questionnaire to Book Mary Miscisin

Let us know about your group by filling out this pre-program questionnaire. Although you may not have all the details of your event in place yet, any information you provide helps Mary get better acquainted with your group and assists her in meeting your specific objectives.
Name *
Email *
Title *
Address *
Organization *
Phone *
Department
Fax
Presentation(s) Requested
Best Method of Contact
If you selected "made to order", please describe:
Date of Presentation
Who is the audience and expected number of participants?
Time and length of presentation (start and end time):
What is the theme and purpose of your event?
Please list three (3) specific objectives for this presentation:
Are there any sensitive issues to be avoided?
Is there anything we should be celebrating?
What are three important things that should be known about your group before addressing them?
What significant events have occurred in your organization or group within the last year?
Please list the names and titles of people in your organization with whom we should be familiar (regardless of whether they will attend the presentation):
Please list any internet links, articles, newsletters, or other information you believe is relevant to helping us better understand your organization and the presentation attendees:
Please provide terminology for the various functional roles within your organization (i.e., Director, Manager, Team Lead, etc.):
Please provide terminology for the various ways in which you refer to the clients you serve (Customer, Patient, Client, Student, etc.):
What is planned to happen before this presentation? (i.e. other presentations, lunch, etc.)
What is planned to happen during this presentation? (i.e. other presentations, lunch, etc.)
What is planned to happen after this presentation? (i.e. other presentations, lunch, etc.)
Please provide the event address and directions to the presentation room/location:
Instructions for parking, permits, check-in ...
How did you hear about Mary Miscisin?

Verification

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