Rick Barrera

Pre-Program Questionnaire Page 3 of 10

Rick's Biography

Client List

Pre-Program Questionnaire

Speech Intros

AV Requirements

B/W Photo

B. What is your conference theme?

C. What will it mean to your attendees?

D. Convention begins?
Date: Time:

Convention ends?
Date: Time:

E. Will my presentation be a:
Keynote Breakout Session General Session
Other (specify):

F. Time frame for my presentation (#1):
Date: Start: End:
Time frame for my presentation (#2):
Date: Start: End:
Time frame for my presentation (#3):
Date: Start: End:

G. There will will not be a coffee break: Approximate time:

H. What takes place immediately before and after my presentation? (Other speaker, meal, break, etc.)
Before:
After:

I. Name of my introducer:
Title:

J. Who are the other speakers on the program with me, if any? (If you have a printed agenda or schedule, please include it in the material you send to me.)

1. Company Speaker:

Topic:

2. Company Speaker:

Topic:

3. Professional Speaker:

Topic:

4. Professional Speaker:

Topic:

K. To be at my best, I typically prefer to have a light dinner from room service and retire early the evening before my presentation. If there is a scheduled function in which my participation would be useful, please list time, place, nature and appropriate dress:
Time: Place:
Function:
Appropriate Dress:

To submit above information and move on to the next section of the questionaire, click the submit form button.

YOUR PROGRAM