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DAVE
CAPERTON

Laugh More and Stress Less

(740) JOYFUL-Y

dave@davecaperton.com

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"The perfect blend of humor and inspiration"

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Pre-event Questionnaire

* Required Fields

Your Information

First Name

Last Name

Company

Address

Title

Work Phone

Work Email

Event Details

Event Contact Person's Name

Event Contact Person's Phone Number

Name of the Event

Date of the Event

Event Location

Estimated Start Time

Estimated Finish Time

Number of People Attending

Conference Theme

Purpose of the Event

Who Will Introduce Dave?

Goals for the Speaker

What A/V equipment will be provided?

I-Mag

LCD

Wireless Lapel

Hand-held Mic

Seating Arrangement

Stage and Lighting Specifics (Select all that apply)

Dimly-lit Room

Brightly-lit Room

Raised Platform

Spotlight on Stage

Backdrop

Will meals be served?

Yes

Not Sure

Select an option

Business Casual

Business Attire

Semi-Formal

Black Tie

Other

If other, please describe

Can you describe the group's job titles and their responsibilities in the organization?

Accommodations & Transportation

Hotel Information

Type of Transportation Provided

Rental Car

Airport Pickup

Taxi

Uber / Lyft

Other

If other, please describe

May Dave bring a guest? *

Yes

No Sure

Will the Dave be able to promote and sell his books and other products for sale?

Yes

Not Sure

Questions for Customizing Content

Describe the terminology used by the group.

What accomplishments can they point to in the past year?

What are some of their greatest challenges?

If you could wave a magic wand to create a change in this group, what would it be?

What do you hope that they will Think, Feel and DO as a result of the program?

What is planned immediately before and immediately after the speaker program?

Any sensitive areas that the speaker should be aware of or avoid?

Anything else you can think of to help the speaker be as effective as possible?

"Most if not all commented that you were the best speaker we ever had."

– Jodie Gilroy
Dickinson County Healthcare System

AN IAMTEEJAY / WIX WEBSITE

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DAVE CAPERTON