Pre-Program Questionnaire

Dear Client: This questionnaire is designed to help Dr. Duncan tailor his program especially for you. Please answer all questions, then return this form no later than three weeks before the event. Thanks for your help in making Dr. Duncan's presentation relate to your organization's current challenges and opportunities. Your Name:    Title:    Organization Name:    Event Title:    Event Date:    Your phone number:    Email address:    Website:    About Your Program 1. What type of meeting is it?       Annual Meeting       Quarterly Meeting       Award/Recognition Event       Management / Leadership Development       Other:         What is your specific objective for the overall meeting?         What is the theme of the conference or meeting?   2. What is Dr. Duncan's role at the meeting?       Opening Keynote       Closing Keynote       Luncheon Speaker       After-dinner Speaker       Other:   3. What are your specific objectives for Dr. Duncan's session? What would you like the audience to walk away with?     A.      B.      C.  4. What major products and/or services does your organization provide?   5. What customers or clients do you serve?   6. Who are your major competitors or threats?   7. What major changes or challenges face your industry and organization?   8. What successes or breakthroughs has your organization recently had?   9. What are the most significant events in your industry or organization during the past year? (mergers, acquisitions, cutbacks, new product or service, legislation, etc.)   10. What is your organization's mission statement, vision, motto or slogan?   11. What goals or themes would you like Dr. Duncan to reinforce?   12. What issues/topics in particular should Dr. Duncan address during his program? Key issues to avoid (if any)? Are there any subjects, words, phrases or concepts that people are negative about and should be avoided?   About Your Audience 13. How many people will be in the audience?   14. What is the percentage of men & women in the audience?     Men   Women  15. Breakdown of audience age (%)   Age 20-30   Age 30-40   Age 40-50   Age 50-60   Age 60 Up 16. Level of education of audience members?   17. # Senior Level Executives:   # Middle Management:   # Support Staff: 18. What are the major job responsibilities of your audience members?:   19. Who are the other professional speakers, industry experts, or company executives on the program?:   Name Topic     Name Topic     Name Topic   20. Please list the names and titles of your senior people who will attend this meeting.:   Name Title     Name Title     Name Title   21. How would you describe the likely "mood" of this audience?   Logistics & Schedule 22. What occurs immediately before Dr. Duncan's place on the program?   23. What occurs immediately after Dr. Duncan's place on the program?     (Please provide an agenda for the day Dr. Duncan speaks and an agenda for the overall event program.) 24. Person introducing Dr. Duncan?   Title   Phone   Email Helpful Information Who spoke at your last meeting?  What did your group like or dislike about speakers they've heard in the past? What did we not ask that you think we should know? How will this program be advertised and participants recruited? Please send any information (annual reports, newsletters, etc.) that will provide further understanding of your organization, its products and services, and its people. Copies of promotional materials, memos, etc., related to this presentation would also be very helpful.                 When completed, click here to

To book Dr. Rodger Dean Duncan as a speaker at your next event, call The Duncan Company at 816-415-1605.