Pre-Event Questionnaire

Please take a few minutes to complete the Pre-Event Questionnaire before your phone meeting and at least 30 days prior to the scheduled event. Your answers will help Dr. Carla customize her presentation for your audience and help you achieve your goals.

Thank you in advance!

* indicates required field

Name:*

Email:*

Event title*

What (if any) is the event theme or slogan used by your organization?*

Appearance #1: Speaker should report to (building and room including address)*

Appearance #2 (if applicable): Speaker should report to (building and room including address)

Appearance #3 (if applicable): Speaker should report to (building and room including address)

Will there be other speakers at the event? If so, please list here or upload a brochure (see below)*

Have you planned any newspaper interviews or TV/radio appearances? (if yes, provide details of each)

Dr. Carla's hotel accommodations (if provided) will be at: (name, address and confirmation number)

What is the demographic makeup of the audience for each presentation? (please describe the average age, socioeconomic background, racial/cultural mix, gender, education, profession, etc.)*

Should the message be targeted to one group in preference to another? If yes, which one?*

What challenges or frustrations does your audience experience in their lives/work? (related to the presentation topic)*

What specific local issues is your audience facing related to the presentation topic? (i.e., youth trends, parent/educator concerns, etc.)*

What are the sensitive issues? Are there controversial issues that should be avoided?*

What three points of information do you want Dr. Carla to address during her presentation(s)?*

How do you want people to feel when they leave the presentation(s)?*

What other information might be helpful for Dr. Carla to know?

Subject:*

Please upload the event brochure or marketing flyer/materials (up to 2 mb permitted)

Acceptable file types: doc,docx,pdf,txt,gif,jpg,jpeg,png.
Maximum file size: 2mb.

Please upload the agenda (up to 2 mb permitted)

CAPTCHA Code:*

Thank you for completing the pre-event questionnaire. We will be in touch shortly to schedule your pre-event phone call.

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