Program Development Questionnaire

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• Program Development Questionnaire Form

Name:

Title:

Phone:

Email:

Web Address:

Type of Meeting:

National Convention - Keynote National Convention - Break Out Session In House Seminar Kick Off After Dinner Entertainment Meeting Facilitation Retreat

Date(s):

Venue:

City:

State:

What Type of Program Do You Want:

Keynote Seminar Breakout Session Meeting Facilitation

What Topic Should Capiz Address:

Communication Sales Management Team Building Customer Care Overcoming Obstacles Networking Relationship Management

Second topic, if any?

Communication Sales Management Team Building Customer Care Overcoming Obstacles Networking Relationshipo Management

Expected Audience Size:

Who are other speaker you have used?

On what topics did they speak?

What does this audience specifically like about its speakers?

What does this audience dislike about its speakers?

Briefly describe attendees' (ages, education, work responsibility etc.)

What are their current challenges and / or "burning issues"?

Who will introduce Capiz?

What happens right before Capiz speaks?

When will the room be available for Capiz to set up?

What happens immediately after Capiz Speaks?

Notes or Comments:

Please enter the security code: