Pre-Program Questionnaire
Please fill this out as thoroughly as possible to help Gleb tailor his program to the specific needs of your audience
First Name *
Your answer
Last Name *
Your answer
Email *
Your answer
Phone *
Your answer
Business Address
Your answer
Desired Program Title
Your answer
Type of presentation?
Name of Event
Your answer
Brief description of event (link is fine)
Your answer
Event Address
Your answer
Event Location Phone
Your answer
Closest Airport
Your answer
Time when Gleb should arrive at event to set up
Your answer
Will you arrange for Gleb's transportation to venue or should Gleb arrange it? If you will arrange, please give transportation details.
Your answer
Will you arrange for Gleb's lodging or should Gleb arrange it? If you will arrange, please provide hotel address (or indicate if it is the same as the venue).
Your answer
Will the hotel be billed to your master account?
Event Date
MM
/
DD
/
YYYY
What time is Gleb scheduled to begins his program?
Time
:
What time is Gleb scheduled to end his program?
Time
:
What is the event agenda? (link is fine)
Your answer
What takes place immediately before Gleb speaks?
Your answer
What takes place immediately after Gleb speaks?
Your answer
Who will be Gleb's contact at the event? Please provide name, email, and phone number.
Your answer
Where at the event location will Gleb's contact meet Gleb when Gleb arrives?
Your answer
What is the appropriate attire for Gleb's presentation if not his usual suit and tie?
Your answer
Who will be introducing Gleb? (Gleb's introduction will be provided)
Your answer
Room Setup (please describe)
Your answer
Will you provide an LCD projector and overhead screen?
Will you provide an over-the-ear wireless microphone? (note, not lapel microphone, as Gleb tends to gesture to express important points and sometimes the lapel microphone gets knocked astray)
Will you be able to print and provide a copy of Gleb's handouts to all attendees?
Will you provide organization logos and/or other relevant graphics resources a month in advance of the event?
Audience members appreciate providing feedback on the presentation and an opportunity to follow up with Gleb. Gleb has a standardized feedback and follow-up sheet that he hands out as part of his presentation for people who wish to fill it out. How will the sheet be collected?
Brief description of your organization/association (link is fine)
Your answer
Please provide documentation to help Gleb understand the state of your organization/association: annual reports, progress reports, sales reports, media coverage. You can provide links here or email them to info [at] intentionalinsights [dot] org
Your answer
Brief description of your industry (link is fine)
Your answer
What were major developments in your industry recently?
Your answer
What are upcoming major developments in your industry?
Your answer
Brief description of audience for Gleb's speech
Your answer
Number of anticipated attendees for Gleb's speech
Your answer
Approximate demographics of attendees for Gleb's speech? (For example, gender ratio, age breakdown, and other relevant information in percentage terms if possible)
Your answer
What are the job responsibilities of those in attendance? If they differ, please provide percentages, for example percentage of managers vs. employees.
Your answer
Names and titles of top people who will attend?
Your answer
What is your objective for Gleb's speech? (how do you want people to behave, think, and feel differently after leaving the speech)
Your answer
What is your objective for the event itself? (how do you want people to behave, think, and feel differently after leaving the event)
Your answer
Who will be the other speakers at the event, if any?
Your answer
Who spoke in the past three years at your events and on what topics?
Your answer
Are there any sensitive areas about which Gleb should be aware or anything he should avoid?
Your answer
What are some insider stories that Gleb can reference?
Your answer
What are some catchphrases, jargon, and slogans that Gleb can integrate into his speech? For each, please describe the attitude of the audience toward this phrase.
Your answer
What is the primary product/service you offer?
Your answer
What differentiates you from your competitors?
Your answer
Who are your biggest competitors?
Your answer
What recent accomplishments are you most proud about?
Your answer
What kind of improvements would you like to see in your organization/association in the next year?
Your answer
What are you most concerned about in the near future?
Your answer
Are any members in the audience suffering from problems such as low engagement, morale, trust, negativity, poor communication? If so, what are some possible causes?
Your answer
Are there any misalignments between organizational objectives and individual audience incentives? If so, what are they?
Your answer
What are your organization/association's greatest strengths?
Your answer
What are your organization/association's greatest weaknesses?
Your answer
What are your organization/association's greatest opportunities?
Your answer
What are your organization/association's greatest threats?
Your answer
Who are the greatest influencers on the audience?
Your answer
Please provide the contact information (name, email, phone) of 3-5 people who Gleb can connect with to further customize the program (ideally, at least 2 top leaders and 1 ordinary employee/association member)
Your answer
Many people express an interest in learning more from Gleb after hearing him talk. Gleb has several books, apps, tip and guideline sheets, audio and videorecordings, online classes, and other content available. Would you prefer to:
Would you like to tap Gleb's expertise in avoiding meeting disasters to help ensure your audience has a great experience?
Is there anything else Gleb needs to know to make your event an outstanding success?
Your answer
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