* Required fields
Name *
E-mail Address *
Name of Group/Organization *
Date/Time *
Location
Event/Occasion/Purpose of Meeting *
Do You Have a Theme? *
Attire For Women In Attendance *
Closest Airport
Est. Travel Time From Airport To Hotel/Presentation Site
Hotel Name (Room Block Only) *
Phone (please enter #s only, 10 digits) *
Confirmation #
Confirmation # OR Meeting Location (please include directions) *
Street Address *
Telephone
Who is the on-site emergency contact of the event?
What time would you like Diane to meet you to set up?
Will You Be Serving Breakfast and/or Lunch? *
May a Guest Sit in on This Program? *
Diane’s books/learning resources *
Will an LCD Projector & Screen Be Available On-Site? *
Will a Wireless Lavaliere Be Available On-Site? *
Introducer (name, title, phone) *
What other speakers have you had recently?
What will happen before and after Diane's presentation? *
Why did you choose this topic? *
If you were the one presenting this program, what's one message you'd be sure to deliver *
What action would you like people to take after this session? *
Number Attending *
Male % *
Female %
Age Distribution *
How well will participants know each other?
Who will attend? Supervisors, Managers, Executives, Line Staff, Professional Staff, Support?
Briefly, what is the nature of the work performed by the group?
Please list a few job situations/duties/issues that can cause stress to my audience as they do their work or in this industry *
What are some of the things that customers or coworkers say or do that may be irritating or cause stress at work? *
Are you interested in purchasing learning resources/books for the attendees? *
What is your website address? *
Who are your main competitors? *
What is the mission/philosophy statement of your company/organization? *
What changes have taken place in your organization/industry in the last few years and what changes do you anticipate in the near future? *
What are some of the "inside" jokes? What are some things I should definitely NOT talk about or poke fun at? *
What is unique about your group? (i.e., unusual hours, travel, red-tape, etc.) *
Please list any specific in-house language, jargon, projects, phrases/sayings, in-house buzz words, acronyms, or words applicable to your group that might be incorporated into the presentation *
For ideas on issues and content, please provide the names and phone numbers of three people who will be attending the conference/meeting
How may I get in touch with the CEO/President/Executive Director of your organization? *
