Questions for Program Customization  
     
  Please help us. Our goal is to provide you with a special program tailored to the specific needs of your organization. This survey will help us prepare for your program. Please answer the questions as fully as possible. Use additional sheets if necessary. Feel free to skip any questions that are irrelevant due to the nature of your program.

Include any information you feel would help us understand your organization. Newsletters and journals are especially helpful. I will call you after I receive this completed survey to discuss the answers with you more fully.

Thank you! Your input will increase the value of your program 		 
     
 
   
Your name:
.
Position:
.
Telephone number:
.
When does the entire conference begin and end?
.
Your program title for my presentation:
.
Date(s) and time(s) for my presentation:

.
What is the specific purpose/significance of this meeting?
..
What is the theme of this meeting?
..
Why is this meeting important?
..
What are your specific objectives for our session together?
..
What types of presentations do the participants in this program make?
..
What speakers have addressed this group in the past and what did your people like most about their presentations? What did they like least about their presentations?
..
Please describe your audience:
.
Number of attendees?
...
Are spouses invited?  Yes              No  
..
Suppliers/vendors?
..
Percentage of  males:   Females:
..
Average age of group
..
Age range:  From:             To:
..

Average income

..
What are the major job titles/responsibilities of 
attendees?
..
Comments regarding audience profile:
.
What are the names and titles of key personnel who will attend the meeting?
..
What is the name and the title of the individual who will
introduce me?
.
What will take place immediately before and after my program?
.
Lists the names and telephone numbers of five or more individuals from your organization for me to interview that represent audience members
.

Name:

Tel No:
.
Name: Tel No:
.
Name: Tel No:
.
Name: Tel No:
.
Name: Tel No:
.

Do you have any additional suggestions that I can 
incorporate into this program that will make it a resounding success?

 Yes              No  
.

IMPORTANT: Please send us all pertinent program material, agenda announcements, company mission statement, magazines, flyers, bulletins, clippings, newspaper articles, newsletters, orientation material, advertising, promotional material, organizational charts, and annual reports that you feel are helpful in customizing your program.
.

 

 



NSA member

One Easton Oval, Suite 550, Columbus, OH 43219
(614) 472-3200 Phone (614) 472-3202 Fax
Robsherman@ShermanLeadership.com
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