Dr. Janet Lapp Pre-Meeting Questionnaire
Meeting Planner/Executive:
Association/Company:
Address:
City:
State/Province:
Zip/Postal Code:
Country:
Phone:	Fax:
E-mail:
Website:
Other contact in case meeting planner not available or in an emergency:
Name:
Phone:
E-Mail:
Your Program
What is your program THEME?
What does the theme mean to your group?
What is the name and title of Dr. Lapp's introducer?
Name:
Title:
E-mail Address:
When is the best time for Dr. Lapp to do her A/V and Room Check?
Option #1
Option #2
What is the dress for your event?
Formal  Business  Business Casual  Client Provided "Theme Outfits"
What is Dr. Lapp's position in the program (e.g. Opening or Closing Keynote, Luncheon Speaker)?
Who are the other professional speakers on this program?
Speaker 1
Day:
Speaker 2:
Day:
What professional speakers have you used in the past?
Speaker: Year: Speaker: Year: Speaker: Year:
Did not work well:
List two major results you would you like to achieve from your conference: 1.
2.
What two major results would you like to achieve from Dr. Lapp's program: 1.
2.
What would make Dr. Lapp's program truly outstanding for you?
Which of Dr. Lapps books would you like to order for your attendees?
Plant Your Feet Firmly in Mid-Air: Dancing With Tigers A Positive Spin We prefer not to order books as gifts
Your Conference Dates:
Date of Dr. Lapp's program:
Exact times of Dr. Lapp's presentation(s)?
Starting: Ending: Starting: Ending:
Where, exactly, will Dr. Lapp's program be held?
Hotel/Conference Center: Meeting Room: Address: City: State/Province: Zip/Postal Code: Phone: Fax:
What awards or announcements are there during your event?
Will there be a meal served before or during Dr. Lapp's program?
Yes No
Will there be an open bar before Dr. Lapp's program?
Yes No
Will you be using Image Magnification (IMAG)?
Yes No
Will a video crew be on site?
Yes No
If so, please provide:
Company Name
Contact Person:
Phone:
E-mail:
Travel
What is the nearest major airport to the meeting site?
Distance to meeting site?
Miles:  Time:
Name of Company:
Contact Information (800#):
Do you wish to use your
Own town car service?  Have Dr. Lapp's office arrange transport?
Audience
How many will attend?
About what % male?
About what % female?
Average Age:
Positions/Occupations:
% staff or line
(describe):
% directors
(describe):
Are spouses invited?	Yes  No
Do you require a translator?	Yes  No
If so, contact information for translators:
Name(s)
E-mail:
Toward which group should Dr. Lapp primarily direct her presentation?
Names/positions of the most senior level people who will be there?
Name 1:
Title 1:
Name 2:
Title 2:
General Background
What have been recent (past 6 months):
Traumatic incidents?
What are the three most important things should Dr. Lapp know about your group?
1.
2.
3.
Is there any jargon with which Dr. Lapp should be familiar (acronyms, titles?)
Who are your three major competitors?
Any additional comments or information that would be helpful in tailoring her presentation for your group?
Please list three persons who represent the typical audience member, with whom Dr. Lapp may speak to in advance?
1. Name:
Email:	Phone:
2. Name:
Email:	Phone:
3. Name:
Email:	Phone:
PLEASE SEND US THE FOLLOWING INFORMATION:
Annual Report Newsletter Marketing Brochures (products, services) Mission Statement Organization Chart Promotional materials, memos, etc. for this program including conference brochure. New employee (or member) orientation packet Anything that can give me an inside picture of you organization
If possible, please furnish Dr. Lapp with the logo, nameplate, or program theme in a format suitable for reproduction on a handout and/or presentation such as PICT or jpeg file, or powerpoint template.