Pre-Program Questionnaire for Education

Pre-Program Questionnaire for Educational Institutions, Associations & Organizations

Thank you for taking the time to help us make Eric’s program at your event a success. With some valuable input from you, Eric will tailor his presentation to fit your goals and objectives.

Step 1 of 4

Organization Details
Name*
First Last
Email*
Enter Email Confirm Email
Work Phone*
Cell Phone*
Logistics
On-Site Main Contact
First Last
Email*
Enter Email Confirm Email
Cell Phone*
Alternate On-Site Contact
First Last
Email
Name of Venue*
Name of Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Closest Major Airport*
Distance Between Airport and Hotel*
Please provide miles/drive time between airport and hotel
Distance Between Hotel and Venue (if Different)*
Please provide miles/drive time between hotel and venue (if venue is different from the hotel)
Distance Between Venue and Airport (If Different)*
Please provide miles/drive time between venue and airport (if airport is different from the venue)
Will Eric be picked up?*
If so, by whom?
If not, what ground transportation do you suggest?
Name of hotel
If different from the venue
Hotel Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

If different from venue
Will Eric's lodging be billed to a Master Account?*

Event Details
Type of Meeting*
Reason for Event/Purpose of Meeting
Theme (if applicable)
Format*
Who, other than Eric, is a Keynote Speaker for your Event?
Audience Attire*
Eric's Attire*
If other, please explain*
Eric's 1st Program Time*

: Hours

Minutes

AM/PM
What happens before Eric's program?*
What happens after Eric's program?*
How long will Eric be speaking?*
If other, please explain
How will the audience be seated?*
How many will be seated at each round/semi-round?*
If Eric is also doing a Breakout, what time does that session start?*

: Hours

Minutes

AM/PM
How long will Eric be speaking?*
If other, please explain
How will the audience be seated?*
If the same as in his first session, please state "Same."
How many will be seated at each round/semi-round?*
IMPORTANT: Eric's program is enhanced by an extensive, dynamic multimedia slide presentation. The success of his program relies heavily on his AV Requirements being met. Please contact those responsible for the AV at your meeting and have them respond to the AV REQUIREMENTS QUESTIONNAIRE. If they need further clarification on any area of Eric's AV Requirements, please have them contact Christie at 303.239.9999 or Christie@EricChester.com. Thank you for your help!
AV Contact Name*
First Last
Cell Phone*
Email*
Enter Email Confirm Email
Are you planning to video record Eric's presentation?*
If Yes, permission is required. Please contact christie@ericchester.com

Pre-Program Questionnaire for Educational Institutions, Associations & Organizations

Step 1 of 4

Organization Details

Logistics

Event Details

Audience

Event History