Event Profile

Company Information

Organization Name:

Contact Person:

Title:

Address:

Address:

Telephone:

Fax:

E-mail:
Leave blank or use valid e-mail address.
Message will not send with invalid e-mail address.

Event Basics

Description:

Date:

Location:

Time Allocation:

Expected number of attendees:

Percent male/female:

Median age range:

Who will be attending?

What happens immediately prior
to our presentation?

What happens immediately after
our presentation?

Event Specifics

Who will introduce Mike?

Would you like a written introduction?

Fax to:

What is the theme of the event?

What are your specific objectives for this event?

List three major points you want emphasized:

1.

2.

3.

Are you planning to audio and/or video tape this presentation?

Audio Only

Video Only

Both Audio and Video

Neither

Please list the "other" speakers and topics for your program (if any):

Name:

Topic:

Name:

Topic:

Name:

Topic:

Who are your three major competitors?

1.

2.

3.

What is the greatest challenge the audience is facing?

Speaker Needs

Unless discussed otherwise, all Mike needs is a lavaliere microphone.

Background Information

In an effort to customize your presentation,
Dream Big!TM requests certain background information:
1. Company mission statement.
2. A current annual report.
3. Any appropriate promotional material
(promoting both your firm and this specific event).

In there anything else you would like us to know?