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Contact Us
Beverly Smallwood, Ph.D.
Magnetic Workplaces
(A division of Leading Resources, Inc.)
Post Office Box 17918

Hattiesburg, MS  39404
Phone: 877-CAN-LEAD
(877-226-5323)

601-264-0890
Fax: 601-261-0471
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PRE-PROGRAM QUESTIONNAIRE

In preparation for our upcoming program for your group, will you please help me meet your needs with the presentation? Please take a few minutes to give me information about your group that will enable me to make the program more relevant to the specific needs of your organization.
Thanks!
Dr. Beverly Smallwood

THE MEETING
Presentation title:
Date(s):
Start time:
End time: 
Breaks:
What is on the program just before Beverly speaks?
Just after she speaks?
What is your Meeting/Conference theme?
Specific purpose of this meeting: (e.g., annual meeting, awards banquet, etc.) 
Introducer's name:
Telephone number:

Is there any publicity for your event that Beverly can do for you, either in advance of the meeting or while she is at your event? Radio or television? Newspaper interview? Article for your organization's newsletter or industry publication?
Radio
Television
Newspaper
Co. or Industry       newsletter
DETAILS: 
Who are the other speakers on the program? What are their topics?
What speakers have you used in the past that covered topics related to the material Beverly will be presenting for you?
Who were your main speakers on any topic at your last meeting?
What did you like and/or dislike? (You may omit names here if you like, but do comment on the material they used and their styles of presentation.)
What kinds of things tend to "wow" the people who will be in this audience?
THE AUDIENCE
Number attending:
Approximate % males and females:
Spouses coming?  YES
NO 
Range of ages, average age
Typical educational background: 
Job responsibilities:
How will your audience members be dressed (e,g., casual, business)?
Sensitive issues that should be avoided:
What are some of the biggest problems faced by your audience?
What are the greatest challenges for the future?
What separates your high-performance people from others?
What significant events are currently affecting members of your audience (e.g., mergers, downsizing, industry trends)?
What jargon or acronyms are common in your audience's vocabulary?
Name 3-5 movers and shakers of your group that will be in Beverly's audience. With your permission, we would like to contact them to sample the perceived needs of your audience members. Please include phone and e-mail, if possible.
What would make Beverly's presentation really special for your group?  What would make it something they would really enjoy, remember, and apply?


LOGISTICS
Location of presentation and venue name:
Address:
Phone:
Meeting Room:
Airport:
Means of ground travel (pick-up person's name and phone, taxi, shuttle, rental car, etc.):
In case of an emergency on the way to the site, who would be an alternate contact if you were not available?
In an ideal presentation for your group, what portion of the program would be: 
(Note:We make our content entertaining!) 
Content: 
%
Entertainment:
%
Thank you so much for the investment of your time in completing this questionnaire. The information you have provided will help us to accomplish our mutual goal of a great presentation for your group!

Cordially, 
Beverly Smallwood, Ph.D.