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Pre-Program Survey
John Eitel
Eventually Yours Corporate Consultants
912 Solem Street
Azusa, CA 91702
Tel: 604.893.7078
Fax: 604.893.7077
Email: info@johneitel.com

Contact Information
*Company Name:
*Your Name:
Event Title:
*Phone:
*Email:

Website:

General Background Information
1. What is your company or association's mission statement, vision, motto or slogan?
 
2. What is your organization's major strength? What makes your organization unique? If applicable, what is your company's competitive edge?
 
3. What are the most significant events to have occurred in your industry, group, or organization during the past year? (mergers, relocations, cutbacks, new product or service, legislation, etc.)
 
4. What goals would you like me to reinforce? What ideas would you like the audience to walk away with?
 
5. What is your conference theme
 
6. What is the specific purpose of this meeting? (Annual meeting, awards banquet, training.)
 
Audience Analysis
How many people will be in the audience?
% breakdown of Males Females:
Males  % Females  %
% breakdown of age:
20-30  % 30-40  %
40-50  % 60+  %
Level of education:
# of Senior Level Executives:
# of Middle Management:
# of Support Staff:
1. What are the major job responsibilities of those in the audience?
 
2. Please list names and titles of your senior people at this meeting.
 
Are spouses invited? Yes No
Helpful Information
1. What did your group like or dislike about speakers they've heard in the past?
 
2. Where did you hear about me? Why did you select me?
 
3. What did I not ask that you think I should know?
 
Please send any information (annual reports, newsletters, etc.) which will provide a better understanding of your organization, its product, and its people. All promotional materials, memos, etc. related to this presentation would also be very helpful