Book Paula

Please take time to complete this questionnaire so that Paula can tailor her message to your specific needs. Click on the ‘Submit’ button to send the form. Please keep in mind that your questionnaire should be sent at least two weeks prior to the program date. Required Fields have an asterisk (*) next to it. All information will be kept private.

Event Questionnaire

Event

Local Address

Street Address

City

State

Zip / Postal Code

Date

Format: mm/dd/yy

Presentation Title

Contact Name

Phone*

Example: (330) 123-4567

Email*

How did you hear about Paula Palmer Green?
 Website Internet Search Referral, Please specify Other, Please specify
Please specify

1. AUDIENCE ANALYSIS INFORMATION
A. Number of Attendees?

B. Average Age Range of Group?

C. Are there any names/titles of your executives or VIP's attending the meeting htat should be acknowledged?
 Yes No

2. THE PROGRAM ITSELF
A. Goals and/or learning objectives for this presentation:

B. Are there any issues/topics in particular that should be discussed during the program?
 Yes No
C. Sensitive issues to avoid (if any):

D. Will the speaker be introduced?
 Yes No
E. Presentation Start Time:

F. Presentation Length:

G. What is your Speaker budget for this event?

Please include additional comments below: