1660 White Pines Ct.
Naperville IL 60563
Phone: 630.803.6511

IMPORTANT: Please return this questionnaire no later than 3 weeks prior to your event.  Thank you.

Thank you for taking the time to complete this brief questionnaire. This information helps Pat Evans ensure his presentation meets your exact needs and expectations.


Date of event:
Website address:
Cell phone:
For emergencies only: Home phone:
Time of presentation:
Meal/Break/Closing (when):
Length of presentation:
Event location (venue/city):
Title of event:
Theme, if any:
Type of event, ie annual meeting, awards ceremony, sales meeting:
Number expected?
Spouses included?
Dress Code:
 Suit and tie  Business casual  Other
Who will introduce the speaker?
Are there other speakers on the program?
Who else is speaking and on what topics?
Before or after Pat Evans?
 Before  After
What will be Pat Evans Role?
What other speakers have attended your events/meetings in the past?
Who was the most successful and why?
How would you finish this statement "This event will be a success if Pat Evans accomplishes the following:"
What are the most important changes happening in your company and industry?
What are the common challenges of your audience members?
What are their concerns?
What are their fears?
What are your major accomplishments as a company?
Has anything exciting or unusual happened in the organization in the past few months that impacted the entire group?
Has anything humorous happened in the organization in the past few months that everyone would be familiar with?
Is there jargon he should be familiar with?
On which target markets or industries does your organization focus?
Who is your typical customer?
What is the primary product/service that you sell?
Who are your major competitors?
If you were giving this talk, what three main points would you make?


Number attending:
Approximate Male/Female ratio:
Average age:
Job titles:
What are the frustrations they face in their lives, company or industry?
Are there any controversial or sensitive topics which should not be addressed?
What issues keep your CEO awake at night?
What are the attendees doing extremely well?
How would you describe your particular culture (structure, current problems, who is the decision maker, any funny interactions between employees)?

Please provide 3 contacts that we may contact prior to the event.

Participant Name 1:
Participant Telephone 1:
Participant Email 1:
Participant Name 2:
Participant Telephone 2:
Participant Email 2:
Participant Name 3:
Participant Telephone 3:
Participant Email 3:


Please briefly describe the meeting room:
If audio/visual equipment is used, is there a staff member who is responsible for making sure all necessary equipment is onsite and working?
When is the best time for Pat to do an audio video room check?
Does the room present any particular challenges, ie odd shape, windows, high ceilings, etc.
Will you be audio- or video-taping this presentation?


Nearest airport:
Distance to meeting site:
Transportation to meeting site, ie cab, private car/driver:
Room reservation will be at:
Hotel Phone:
Hotel Address:
Hotel City:
Hotel Zip:
Room Confirmation will be provided by (date):
Hotel Room Confirmation Number:
Event Location:
Event Location Address:
Event Location City:
Event Location State:
Event Location Zip:
Event Location Telephone:
Event Location Fax:
Additional Comments:
Will you allow Pat to sell copies of his book at your event?


What three things should Pat know about your group?
Meeting Planner:
1660 White Pines Ct Naperville, IL 60563     Phone 630-803-6511     patevans@evansales.com