Questionnaire

Questionnaire

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Speaker

Name of Your Organization

Your Email Address

Date of Speaking Engagement

Hotel where the speaker is staying (if applicable and subject to speaker’s approval)

Hotel Address

Street Address

Address Line 2

City

State

Zip Code

Country

Hotel Phone

Hotel Confirmation Number

Check-In Date

Check-In Time

Check-Out Date

Check-Out Time

Closest Airport

Name of Venue

Venue Address (if different than hotel)

Address Line 1

Address Line 2

City

State

Zip Code

Country

Name of Conference Room

Name of Conference

Major Objective

Theme

Attire

Specific Objectives For This Speaker's Presentation

Name & Title of The Introducer

Name, cell number & confirmation of the person or car service that will transport the speaker to and from the airport, hotel and event

Dates and times that the speaker will be picked up at the airport, hotel, and event by above

Distance from airport to hotel

Distance from hotel to event

Name of last year's speaker

Exact schedule of events for the speaker (include times please)

Audience demographics:

Size of audience

Average age

% Men

% Women

General Description of Attendees

If this speaker could leave your group with two thoughts, what would they be?

Speaker's contact prior to meeting

Title

First Name

Last Name

Office Phone

Cell Phone

Speaker's contact at meeting

Title

First Name

Last Name

Office Phone

Cell Phone

Please list any social media username, including platform, that may be used for this event. [For example, we are @aeispeakers on Twitter, Instagram and Facebook.]

Is there an event hashtag?

Book Signing

Please contact Melissa Fiorillo at melissa@aeispeakers.com or 617-782-3111 to discuss options for ordering, shipping, quantity and pricing for your book signing. Book orders should be arranged no less than 30 days prior to the event.

Any other information that the speaker should be aware of?

Audience demographics:

Speaker's contact prior to meeting

Speaker's contact at meeting

Book Signing

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