EVENT INTAKE FORM

C3 Financial Services ● 130 Oakhaven Drive ● Wexford, PA 15090
Email address *
CONTACT
Organization’s Name *
Organization’s Address
Contact Person for this Event
Contact Person's Title
Office Phone
Cell Phone
Email
Fax *
NOTE: Carl will use the cell phone listed above during his travel to your event.
NOTE: To contact Carl during his travel to your event, please call 571-422-9776.
TRAVEL
1. What are the airports for Carl to consider when flying to this event?
Is there one airport that you would recommend over the others?
NOTE: Carl flies from Pittsburgh International Airport
2. Will someone pick Carl up from the airport or would you rather have him rent a car or take a taxi?
3. The only travel expense your organization is contractually required to arrange and cover is lodging. What is the name, phone number, and address of where Carl will be staying?
What is the confirmation number for his room?
SHIPPING
1. If we decide to ship product, where is the best place to send it? Your Organization, Event Conference Center, or Hotel?
Shipping Address
Attention (person or department)
2. Ideal arrival date of packages?
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EVENT LOGISTICS
1. Where will Carl be speaking? Exact name of the location where Carl will be presenting:
Complete address of the location where Carl will be presenting:
Phone number of the location where Carl will be presenting:
2. What are the dates of your entire event?
Date and time of Opening Session?
Date and time of Closing Session?
Date(s) Carl needs to be at the event?
Webpage with event details (i.e. theme, schedule, etc.)?
3. Is there a dress code or guidelines for appropriate attire?
4. Time frame of Carl’s session(s)? Session One: Date
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Start Time
Time
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End Time
Time
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Amount of time allotted for Carl’s presentation
Session Two: Date
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DD
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YYYY
Start Time
Time
:
End Time
Time
:
Amount of time allotted for Carl’s presentation
Session Three: Date
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DD
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YYYY
Start Time
Time
:
End Time
Time
:
Amount of time allotted for Carl’s presentation
Session Four: Date
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DD
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YYYY
Start Time
Time
:
End Time
Time
:
Amount of time allotted for Carl’s presentation
THE AUDIENCE
1. Number attending
2. Range of ages
3. Average age of group
4. Percentage of males
Percentage of females
5. Educational background
6. What are the major roles and/or responsibilities of the audience?
CREATING A WINNING PROGRAM
1. What is the theme of your event?
2. Imagine you have a blank sheet of paper and you could create an ideal conference by just writing words. What would you write? What are 2-3 big goals you want to achieve during your entire event to empower your attendees to achieve financial wellness?
3. What is the specific purpose of the session(s) at which you are asking Carl to present (training, competition, awards, annual meeting, etc.)?
What specific outcomes do you want Carl to achieve with his presentation(s) that will assist you in achieving your goals for your event?
Are there any sensitive issues that should be avoided?
4. Are there any specific problems or challenges your organization is facing that you want Carl to address if it fits into his presentation(s)?
5. Are there any positive opportunities your organization is experiencing (or close to experiencing) that you want Carl to address if it fits into his presentation(s)?
6. What specific characteristics/behaviors are you looking to champion with your members? In other words, what characteristics/behaviors separate your people from others in your organization?
7. Any other suggestions to help Carl make this program your best ever?
Thank you for sharing your responses on this Intake Form. This information will help Carl design programs that fit your event goals and desires!
C3 Financial Services ● 130 Oakhaven Drive ● Wexford, PA 15090
A copy of your responses will be emailed to the address you provided.
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