Pre-Program Questionnaire

Thank you for taking the time to fill out this information.  The more information I have, the better I am able to tailor the presentation to your group and give a meaningful presentation that will meet your objectives.  Fill out only the questions that are applicable to your group or industry.  After reviewing everything you send, Janice will call you to discuss specific ideas for the content that will achieve your objectives.

Fill out the information below on-line or print it out and fax or mail it to Janice Madariaga at the following address:

Life Skills Training, Inc.
P.O. Box 426
Paonia, CO 81428

Phone 970-527-5519 or 1-877-688-7529
Fax: 970-527-5518
E-mail Janice@seeds-of-success.com

 

Your Name:
Today's Date:
Company:
Title:
Phone:
Fax:
E-mail
Website:
 
 
Address:
City/Province:
State:
Zip/Postal Code:
Country:
 
 
 
Meeting Information  
 
 
Meeting Date :
 
Meeting Length :
 
Purpose of Meeting (Convention, Sales, etc.):
What is your program theme?
How will attendees be dressed?


Audience Analysis

Number Attending:         Age Distribution:

 %Male       %Female

Who are the people attending? (Supervisors, Managers, Executives, Line Staff, Professional Staff, Support, Etc.)

Briefly, what is the nature of the work performed by the group? 

What are some of the changes that are currently impacting your company and industry? 

What are some of the challenges senior management are currently facing? 

What are some of the challenges your audience is currently facing? 

What are some of the fears and concerns of the audience? 

What are some examples of this audiences victories and celebrations? 

Are there some key points you would like to see covered in this presentation? 

Are there any sensitive issues that should not be covered?

 What percentage entertainment vs. high content information and strategies would you like to see?

What is the mission or philosophy statement of your company/organization? 

Please list three people of value for Janice to interview(please include their name, title, phone, fax and e-mail):

Travel

What is the nearest major airport to the meeting site?

Estimated travel time from airport to lodging site and from lodging site to meeting site?

Would you prefer to meet Janice at the airport or have her take a cab?

In case of emergency or flight delay, who and where should Janice call?

Miscellaneous Information

Please be assured that all information you provide will remain confidential.

Please send an agenda of the meeting as soon as possible. Also include any current brochures or information about your company/organization.

Is it possible for one or two guest to sit in on Janice's program? Yes No

 
 Life Skills Training, Inc.
 1.877.OUTPLAY  (1.877.688.7529)
 Outplay Your Competition!
 1.970.527.5519  Fax 970.527.5518
 P.O. Box 426
 Paonia, CO 81428

 ©Life Skills Training, Inc.
Planting the Seeds of Success:
Take Your Business, Your Relationships,
Your Life to the Next Level.