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The following questionnaire will greatly assist Mr. Hansen in preparing for your meeting. Any collateral materials (i.e. brochure, promotional video, annual report, etc.) on your company and/or group for Mr. Hansen's review would also be of great value.

Please complete all applicable information.
For questions regarding this form please call our offices at 800-433-2314 and ask for Lisa Williams.
Fax this form to our offices at: 949/722-6912
Mail to: Mark Victor Hansen
P.O. Box 7665
Newport Beach, CA 92658
E-mail to: lisaw@markvictorhansen.com

Client:
Appearance Date:
Please complete and return by:
Your Name
Title
Company/Organization
Phone Number:
Fax number:
E-mail address
Web site
Best time for our office to reach you


I. THE PROGRAM
A. What is your program THEME?
B. What does this theme mean to your group?
C. What kind of meeting is it? (annual meeting, awards banquet, etc.)
D. What are your specific objectives for my presentation?
E. Are there any sensitive issues that should be avoided?
F. Who is responsible for calling this meeting? (HR, Sales, Marketing, etc.)
Name:
Title:
G. What is the name and title of Mr. Hansen's introducer?
Name:
Title:
H. Exact times of Mr. Hansen's presentation?
(Please attach program agenda)
Starting: Ending:
I. There will / will not be a coffee break.
Approximate time:
J. What is Mr. Hansen's role in the program? (Opening or Closing Keynote, Luncheon Speaker, etc.)
K. Which company executives and/or industry experts will be speaking at this meeting?
Speaker:
Topic:
Day:
Speaker:
Topic:
Day:
L. Who are the other professional speakers on this program?
Speaker:
Topic:
Day:
Speaker:
Topic:
Day:
M. What professional speakers have you used in the past?
Speaker:
Topic:
Speaker:
Topic:
Speaker:
Topic:
N. What did you specifically like/dislike about their performance? Why?
Like
Dislike:


II. AUDIENCE ANALYSIS
A. Audience:
  • Number attending?
  • Are spouses invited?
    		• Yes   No
  • Percentage of males
    		• % / females %
  • Average age of group?
  • Average income of group
    		• $
  • Job titles:
    • B. Toward which group should Mr. Hansen primarily direct his presentation?
    C. Who are the people within your organization responsible for the following:
  • President/Exec. Director:
    • Name
    Exact Title
    Phone number
  • V.P. of Sales/Marketing
    • Name
    Exact Title
    Phone number
  • Sales Training Manager:
    • Name
    Exact Title
    Phone number
    D. What issues keep your CEO awake at night?
    E. What is the single most frustrating issue for your VP of Marketing?


    III. GENERAL BACKGROUND INFORMATION
    A. What three main things should Mr. Hansen know about your group?
    1.
    2.
    3.
    B. On which target markets/industries does your organization primarily focus?
    C. Who is your typical customer (e.g.: CFO, VP of HR, Purchasing Agent, Consumer)?
    D. What is the primary product/service that you sell?
    E. Who are your major competitors?
    F. Any additional comments or information that would be helpful in tailoring this presentation for your group?


    IV. LOGISTICAL INFORMATION
    A. What is the nearest major airport to the meeting site?
    Distance to meeting site? Miles:
    Time:
    B. For transportation from the airport to the meeting site would you prefer:
    To have Mr. Hansen met at the airport?
    Where?
    By who?
    Emergency #
    To have Mr. Hansen take a cab?
    Approximate cost?
    N/A (Local Meeting)
    Other
    C. Exactly where is the meeting?
    Venue:
    Address:
    City:
    State:
    Zip:
    Phone:
    FAX:
    Meeting Room:
    D. Hotel Mr. Hansen will be staying:
    Address:
    City:
    State:
    Zip:
    Phone:
    FAX:
    *** Confirmation # for Mr. Hansen's room reservation:
    E. If Mr. Hansen has any problems/emergencies on his way to the program, who should he contact?
    Name:
    Business Phone:
    Home Phone:
    Cell Phone:
    F. Mr. Hansen typically dresses in formal business attire. Should you have a special request (i.e. western or luau theme, etc.) please address here:

     


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