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Pre-Program Questionnaire

Welcome to the Pre-Program Questionnaire! Please fill out this form so we can evaluate your individual needs and prepare a focused program for your group. The form fields marked with an asterisk must be filled out to submit the form. Thank you for taking the time to fill out this questionnaire!

Contact Information:

Name *
Company *
Title *
Department
Phone *
Extension
Email *
Address *
City *
State *
Zip Code *
Country *

Speaking Experience:

Type of speaking:

Informative

Educational

Sales

Marketing

Leader
Persuasive

Scientific

Other

Typical Audience:

Number:
< 10

10 – 20

20 – 50

50 – 100

100 – 250

250 – 1000
Type:
Customers

Management

Colleagues

Other

Frequency of Speaking:

Daily

Frequently

Occasionally

Rarely

Importance of Speaking:

Extreme

Very

Relatively

Not Very

Previous Coaching:

No

Yes ( please  explain: )

Goals:

What are your strengths as a speaker?
What do you need to improve?
What would you like to improve?
What do you admire in other speakers?
What do you dislike about presentations others make?
Comments, questions, or things we should know about you:


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