Pre-Questionnaire

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Pre-Questionnaire

Pre-Conference

* Indicates required field

Organization *

Event Date/s *

Conference Theme *

State *

Type of Event (State conference, School, etc) *

Date I will speak *

# of attendees *

Conference Website *

Audience *

Students Adults Both Other

Microphone *

Handheld Cordless

Service *

Workshop Keynote Both

Keynote Time (From _____to______) *

NA if not applicable

Workshop Time (From ____ to ____) *

NA if not applicable

Will I be able to show a power point? *

Yes No

Remote Clicker Provided *

Yes No

Event Technician *

Event Technician Email *

Closest Airport *

Conference Hotel *

If there is no conference hotel just put NA.

Address *

Line 1

Line 2

City

State

Zip Code

Country

Why are they bringing me in? *

Brief Description of Space I will be speaking in. *

Date of my 14 day out meeting *

Time of 14 day out meeting *

Name and position of the person I will speak with?? *

Contract Information

Responsible Party as indicated on the contract *

Client Responsibilities *

ALL Transportation Ground Transportation No Transportation Hotel

# of Hotel Nights Compensated for by Client *

Fee *

Lori L Speaks Responsibilities *

All Transportation Ground Transportation Books Follow-Up Meetings VIP Workshop Hotel

Day of Event Information

Day of Event Contact *

First

Last

Where do I go when I get to the event? *

Phone Number *

Time expected at the event *

Position *

Comment *

Submit

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STUDENTS
Faculty & Staff
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