Pre-Program Questionnaire

Please complete this form to assist Charlie in preparing the best program for you. Required fields are marked with * and are bold.

 

*Contact Name:
Your name is required.

*Contact Email:
Your email address is required.Invalid email address.

*Contact Cell Phone:
A phone number is required.

Name of your organization:


What is the name of your event?


Is there a theme to the event (sales kickoff, preparing for change, awards
event, continuining education, launching the year, etc)?


Because I often use DVD clips, what is the contact information for the tech
person I could work with in your organization?


What is the dress attire for the event?


How many people will be attending and what is the make up of the audience
(sales, tech, teachers, administrators, male/female ratio, etc)?


What is the primary purpose of the event? Any specific objectives?


What are some specific challenges your people are facing?


What are some recent accomplishments of your organization?


Are there any "seeds" you would like Charlie to plant?


Summarize the mission/vision of your organization.


Please provide me with contact information of two of your top performers
(if applicable). This allows me to personalize the program and help the
audience find mentors in their own organization.


Are there any people in the audience you would like Charlie to recognize or poke
fun at? Who would be fun to bring up as a "volunteer"?


Is there any specific jargon I should use at the meeting?
Do you have any phrases that you use quite a bit?


Are there any topics to stay away from?


Are there any other suggestions for me to make this the best program ever?


When will I be speaking (date, time)?


What is the exact amount of time I will be speaking?


What is your budget for this event?

Learning Tools

Most audiences want something to help them continue learning after the presentation. Charlie's 2008 book "Stoke the Fire Within: A Guide to Igniting your Life" allows the audience to take home his inspirational message and tools. How do you wish to handle these? (please check all that apply)

Purchase at quantity discount to distribute to participants at the event?

Offer learning materials to participants for purchase at the event?

Provide a handout master? (no charge)

Charlie may offer his books/tapes for sale following the presentation.