What is your program THEME?
What does the theme mean to your group?
What is the name and title of Natalie's introducer? Name: Title: E-mail Address:
When is the best time for Natalie to do her A/V and Room Check? Option #1 Option #2
What is the dress for your event? Formal Business Business Casual Casual Client Provided "Theme Outfits"
What is Natalie's position in the program (e.g. Opening or Closing Keynote, Luncheon Speaker)?
Who are the other professional speakers on this program? Speaker 1: Day: Speaker 2: Day:
What professional speakers have you used in the past? Speaker: Year: Speaker: Year: Speaker: Year:
What specifically worked or didn't work well about their performance? Worked well: Did not work well:
List two major results you would you like to achieve from your conference: 1. 2.
What two major results would you like to achieve from Natalie's program: 1. 2.
What would make Natalie's program truly outstanding for you?
Which of Natalie's products would you like to order for your attendees? Zenergy Membership We prefer not to give out gifts at this time.
Your Conference Dates:
Date of Natalie's program:
Exact times of Natalie's presentation(s)? Starting: Ending: Starting: Ending:
Where, exactly, will Natalie's program be held?
Hotel/Conference Center:
Meeting Room:
Address:
City:
State/Province:
Zip/Postal Code:
Phone:
Fax:
What awards or announcements are there during your event?
Will there be a meal served before or during Natalie's program? Yes No
Will there be an open bar before Natalie's program? Yes No
Will you be using Image Magnification (IMAG)? Yes No
Will a video crew be on site? Yes No If so, please provide: Company Name: Contact Person: Phone: E-mail:
What is the nearest major airport to the meeting site?
Distance to meeting site? Miles: Time:
Name of Company: Contact Information (800#):
Do you wish to use your own town car service? have Natalie's office arrange transport?
A. Audience:
How many will attend?
About what % male? What % female?
Average Age:
Positions/Occupations: % staff or line (describe): % management (describe): % directors (describe):
Are spouses invited? Yes No
Do you require a translator? Yes No If so, contact information for translators: Name(s): E-mail:
Toward which group should Natalie primarily direct her presentation?
Names/positions of the most senior level people who will be there? Name 1: Title 1: Name 2: Title 2:
What have been recent: (past 6 months)
Traumatic incidents?
What are the three most important things Natalie should know about your group? 1. 2. 3.
Is there any jargon with which Natalie should be familiar (acronyms, titles?)
Who are your three major competitors?
Any additional comments or information that would be helpful in tailoring her presentation for your group?
Please list three persons who represent the typical audience member, with whom Natalie may speak to in advance? 1. Name: Email: Phone: 2. Name: Email: Phone: 3. Name: Email: Phone:
PLEASE SEND US THE FOLLOWING INFORMATION: 1. Annual Report 2. Newsletter 3. Marketing Brochures (products, services) 4. Mission Statement 5. Organization Chart 7. Promotional materials, memos, etc. for this program including conference brochure. 8. New employee (or member) orientation packet 9. Anything that can give me an inside picture of you organization
If possible, please furnish Natalie with the logo, nameplate, or program theme in a format suitable for reproduction on a handout and/or presentation such as PICT or jpeg file, or powerpoint template. Only press submit once. It will send the form when you give permission for your email to be forwarded. Thank you!
