Speaking Engagement Questionnaire

Your Information Company/Organization * require First Name * Last Name * Title Phone * Fax Email Address * Web Site Address Address City State Zip Event Details Preferred Speaking Date Location of Events Type of Meeting Desired Topic Length of Presentation Occasion Audience Details Audience Size Percentage Male/Female Average Age of Attendees Average Income of Attendees Attendees Will Be Dressed In Business Attire Business Casual Casual/Resort Additional Info About the Group Additonal Information Please identify anyone who will speak either before or after along with their topic. May we have educational resources available for sale at this event? Yes No What is your budget for this part of the program? Who referred you? Please list any other information that will be helpful to our preparation. Name the contact on day of the event. List the mobile phone number of the contact on the day of the event. Desired Effect of Tommy's Presentation? Questions or Comments. Before you submit the Questionnaire, please take a moment to go back over your information and verify that everything is correct.