Pre-Program Questionnaire

Susan needs your help! In order to “customer-ize” her program for your group, would you please answer the following questions:

Your name:
Your title:
Event Name:
Date of Susan's presentation:

Susan's Start Time: End time:
Specific location:
Program or Event theme?

Room set-up: Theater Classroom Round tables Other Describe: Susan will provide the introduction script to be read as is by:
Name:
Title:
What will be happening immediately before and after Susan?
Before:
After:
Who are other professional speakers at this event? (if any)

Who will be in the audience?
Number expected: % Male: % Female:
Job titles:
General job responsibilities
What is your most important objective for Susan's presentation?

	Are there any sensitive issues Susan should avoid?
	What is an often-used phrase (or inside “joke”) of your organization?
What are three specific workplace problems or challenges your audience faces that causes them worry or stress? (In other words, if several members of this audience were having drinks together, what would they start griping about after the third drink?)

	Who were the last two speakers you used in this slot?
Best:	What did you like best/least about past speakers you have hired?
Least:
If Susan could leave your group with just two thoughts, what would they be?
	Thank you very much for your time!

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"Thank you for an OUTSTANDING presentation at the IAAP Annual Seminar. I have had RAVE REVIEWS including: 'Speaker was excellent! Hope you have her again in the future.' 'Great speaker and relevant material.' 'The speaker was fantastic.' In a nutshell, we all loved you and hope to be able to have you come again in the very near future. It was very nice working with you…You were so helpful and you made my job much easier."

Beverly Hoppel,
Chattanooga, TN

"What can I say? You were GREAT! Thank you for being our recognition luncheon keynote speaker. You made me look like a genius for hiring you."

Dan Hall,
General Electric

"I think the motivation you provide is extraordinary...You definitely helped our mission of empowering women to succeed in the workplace!"

Senlin Ward,
Dress for Success

"You are one fantastic, outstanding speaker. I have attended many seminars but have not heard anyone as superb as you."

Lydia Parrinello
City of Bayswater
Perth, Western Australia

Susan Miller, MA, MEd
Re-Energizing Communications, Inc.
Transylvania Beach Road
Prospect, KY 40059-1169 USA

E-Mail:     susan@susanmillerspeaks.com
Phone:     502-228-5558
Toll Free: 1-8-NOT-BORING
Fax:         502-228-6272

Professional
National Speakers Association Member