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Speaker Packet

Client Pre-Program Questionnaire

Name of Client or Group:
Date of Program:
Program/Event Topic:
This questionnaire will enable Ulrich to tailor his presentation to the specific needs of your organization. Please answer all relevant questions as completely as possible, skipping over any that may not apply due to the nature of your program.
Your response to these questions is the first step. Upon receipt, we will contact you to set up a pre-program call to insure that Ulrich understands your objectives for his appearance. We appreciate your time and attention to these details.
Please complete and submit this document. If you have any questions, please contact us at (904) 891.8589.
Client Contact Information
1. Name:
2. Address:
3. Phone: (include Area Code)
Fax: (include Area Code)
4. Email address:
5. Website URL:
6. Meeting location:
7. Address:
8. Phone: (include Area Code)
Fax: (include Area Code)
9. Meeting room:
10. Closest airport:
11. Distance from airport to meeting room in miles:
and minutes:
12. Ulrich’s hotel name:
13. Hotel address:
14. Hotel phone: (include Area Code)
15. Confirmation number:
16. Distance hotel is from meeting location in miles:
and minutes:
17. Lodging Requirements
  • Please reserve a king bed, non-smoking room for the night prior to the event
  • Guarantee for late arrival
  • Ulrich usually arrives the night prior to his presentation and will depart after his presentation, unless other arrangements are made
18. Will someone be meeting Ulrich at the airport? Yes No
19. If no one is meeting Ulrich at the airport what is the best way to get to the hotel?

The Meeting
20. Meeting start time:   AM PM
end time:   AM PM
21. Ulrich’s program start time:   AM PM
end time:   AM PM
22. What happens before and after Ulrich’s presentation?
23. Who will introduce Ulrich?
24. Specific purpose of the meeting:
25. Top three objectives for Ulrich’s presentation:
26. Sensitive issues to avoid:
27. Are there any messages that you would like Ulrich to reinforce?
The Audience
28. Number of attendees:
Female %:
Male %:
Age range:  to 
Spouses or family invited? Yes No
29. General Description of Audience:
30. What other information should Ulrich know about the audience?
The Organization
31. What is your organization most proud of?
32. Please provide a "state of your industry" statement:
33. Mission statement for your organization:
34. Are there any industry key phrases often used?
35. Primary products and/or services:
36. Who are your customers by type?
37. Who are your major competitors by name and product category?
38. Biggest opportunities present and/or future?
39. Biggest challenges your organization is facing?
40. Do you have any corporate "heroes" (other organizations or leaders admired, studied or referenced by your managers)?
41. What training programs have the audience members been through?
42. What is unique about your group?
43. How did you hear about Ulrich?

44. What prompted you to hire Ulrich for your event? (Please check as many as apply)

45. Are there any other speakers on the program, if so identify them by name, title and topics they will discuss?
46. What other presentation topics would you considered for the future?
Audio Visual Requirements for Presentations
The following are required:
  • LCD Projector
  • Screen
  • One wireless lavalier microphone & Body Pack
  • One mini jack (to allow for connection into the sound system from laptop)
  • The meeting room should be fully lit
  • If this is a concurrent session or training segment, the above requirements remain the same.
47. Have these arrangements been made? Yes No
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