Company/Organization Name:
_________________________________________
Address:
__________________________________________________________
Seminar Date:________________________Location: ________
______________
Time of Program:
___________________________________________________
Person filling out this assessment?
______________________________________
Phone_______________________Address_______________________________
_____________________________E-mail address?
________________________
- Would you like me to conduct an assessment of your
organization? __________
- Would you like me to design an accountability feature
in my program? ________
- Can I suggest a few ways to reinforce my message
after the program is over? __
I. Audience Analysis:
Number attending?_________ Type of audience?
Executives________
Middle Mgmt______________
Other?___________________________
Average age of group_______ Range of ages: from_____
to_________
Educational
background:____________________________________________
Would you describe the group as:
_____Fun-loving _____Demanding _____Participate
_____Serious _____Open/cooperative _____Other
II. General Information
1. What positive objectives would you like to see met by
the program?
2. Is there a theme for this meeting? (I can help you
design one if you want)
3. What are the three biggest challenges facing your
company?
a.___________________________________________
b.___________________________________________
c.___________________________________________
4. What should I know about the people in your group
before I start my program? Is there any problems, resentment or
personality conflicts that I should know about?
5. What are the challenges or obstacles facing your
association/organization? (e.g. competition, shrinking resources etc.)
6. What significant events have occurred within your
industry or to your group during the past year?
7. How is technology affecting your workplace?
8. Please describe how change is impacting on the people
in your organization.
9. Has your organization gone through or expect to go
through any type of downsizing or restructuring? Please explain.
10. What top three issues I can address that you would
like to see improve?
11. Are there any suggestions you can make that will
help make this program even more successful?
12. When this program is over, what do you want to say
about Greg Smith?
13. Please provide us with a directory or at least three
names of other people we can contact for further research:
Name:___________________________________________________________
Organization:___________________________________________________
Position:________________________________________________________
Tel.
No._________________________________________________________
Name:__________________________________________________________
Organization:___________________________________________________
Position:________________________________________________________
Tel.
No._________________________________________________________
Name:__________________________________________________________
Organization:
___________________________________________________
Position:
________________________________________________________
Tel.
No._________________________________________________________
14. Are there other meetings that you will be conducting
in the next 12-18 months where you may need a speaker for a keynote,
seminar or workshop?
_________________________________________Date__________________
15. If you are pleased with my services, would you mind
writing a letter of recommendation for my files? Yes_______No______
16. What else do I need to know to be successful?
