KDM Pre-Program Form

Know More, Live More, Be Moore

PRE-PROGRAM QUESTIONNAIRE

Thank you for the opportunity to work with you. These questions are designed to assist my staff and I customize a program specifically suited to the needs of your group. Please take a moment to answer all the questions fully and return the form to my office via e-mail info@be-moore.com or print and mail to Knowledge Driven and Moore, LLC. PO Box 4343 Huntsville, AL 35815.

We would also appreciate receiving any printed materials on your group that may help us with background information. Here is a list of items that help us to understand your needs:

> Corporate reports
> Media Materials
> Newsletters
> Other information associated with your business
> Promotional Materials designed for the meeting
> Promotional Materials for the business
> Product Literature
> Website addresses regarding your business

Thank you in advance for your help. We at KDM look forward to providing a dynamic speaking event that will add value to your organization.

GENERAL INFORMATION:
Name of Group:
Date of Presentation:
Type of Event:
Address:
Office Telephone:
Cell Phone:
Email Address:
Fax:
Website:
Name of planner or contact person & Title:
Contact Phone:
Contact Cell:

TELL US ABOUT YOUR EVENT:
Event Logistics
Location:
Address:
Telephone on Site:
Fax:
Meeting Room Information:
Airport to Arrive At:
Distance from Airport in Miles:
Distance from Airport in Minutes:
Distance from Hotel:
How will I be transported from the airport to your site?

TaxiRental CarDriver
Driver's Name
Phone:
Home/Emergency Phone:
Email:
Event Information
Conference Theme/Title:
Presentation Topic:
Event Goals & Professional Concerns
What are the major goals of this event/program?
What is your organization's/association's purpose, philosophy, specialty, market or product? Who is your customer? Who are your competitors?
What are the biggest challenges/changes facing your industry and/or organization?
What are the biggest challenges/changes facing our audience/attendees?
What are you particularly proud of as an organization, industry, agency or institute?
Please identify any in-house language, jargon, phrases or words applicable to your group that might be relevant to this presentation.
Are there any topics, issues or items that are sensitive that Kevin should steer clear of?
Tell us about your past presentations? What was successful and/or not successful? This will be very helpful in making sure that my presentation meets your needs.
What speakers and subjects have you used in the past? [Include speaker name(s) and subject matter(s)]
Event Detail
Start Time of Event:
End Time of Event:
Kevin's Start Time:
Kevin's End Time:
Any Breaks?

YesNo
What is the appropriate attire for the presentation? Business, Casual, Business Casual, Formal or Specify?
What precedes my presentation?
What follows my presentation?
Who are the other speakers on the program? [Include speaker name(s) and topic(s)]
What is the name and title of Kevin's introducer?
Title:
Phone:
Email:
Is there any publicity work I can help you with while I am at your event?

NoYes, RadioYes, TelevisionYes, Other
Specify other:
Event Goals and Professional Concerns
What are the major goals of this event/program?
What is your organization's/association's purpose, philosophy, specialty, market or product? Who is your customer? Who are your competitors?
What are the biggest challenges/changes facing your industry and/or organization?
What are the biggest challenges/changes facing our audience/attendees?
What are you particularly proud of as an organization, industry, agency or institute?
Please identify any in-house language, jargon, phrases or words applicable to your group that might be relevant to this presentation.
Are there any topics, issues or items that are sensitive that Kevin should steer clear of?
Tell us about your past presentations? What was successful and/or not successful? This will be very helpful in making sure that my presentation meets your needs.
What speakers and subjects have you used in the past? [Include speak name(s) and subject matter(s)]

TELL US ABOUT YOUR AUDIENCE:
Total number attending?
Spouses attending?

YesNo
Percentage male/female:
Average age?
Average annual income:
Educational background:
Major job responsibilities of audience:
Will there be any "special guests?" Please explain.
Why is your group attending this meeting (voluntary, mandatory, etc.)?
How will they be notified?
Who is the most respected or highest ranking among your audience? Name and Title
Describe any uniqueness to the group or a certain cultural make up?

Would you provide us with contact information for one or two key people from your
group who will be in Kevin’s audience? We would like to contact them (with your
permission) to gather additional information that may be valuable to his presentation.
Name:
Position/Title:
Phone:
Email:
Name:
Position/Title:
Phone:
Email:

TELL US ABOUT KEVIN’S ACCOMODATIONS:
Hotel Name:
Address:
Phone:
Fax:
Reservation Confirmation Number:
Distance from Meeting location in Miles:
Minutes:
Reservation Requirements

Kevin requires a King Size Bed nonsmoking room. When possible, please be sure to guarantee Kevin’s reservations for late arrival and have the confirmation sent directly to our office. Please arrange for direct billing for room and tax to your master account and KDM will pay for incidental charges and bill you later. His arrival will be the night before event presentation and will depart after his presentation. An itinerary will be emailed before presentation.

Thank you for your assistance in this matter. We look forward to your event.
Should be Empty:

GENERAL INFORMATION:

TELL US ABOUT YOUR EVENT:

TELL US ABOUT YOUR AUDIENCE:

TELL US ABOUT KEVIN’S ACCOMODATIONS: