Ann McNeill Speaking Event Questionnaire
Thank you for your interest in booking Ann McNeill for your upcoming event. Please complete the form below.
Part 1: Primary Contact
Date of Request
-
Month
-
Day
Year
Date
Sponsoring Organization
*
Main Contact
*
First Name
Last Name
Title
*
E-mail
*
Phone Number
*
-
Area Code
Phone Number
Part 2: Secondary Contact
Secondary Contact
First Name
Last Name
Phone Number
-
Area Code
Phone Number
Email
example@example.com
Part 3: Event & Program Details
Date of Event
-
Month
-
Day
Year
Date
Time of Event
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
Program name
Program Theme
Program Focus
Type of Event
In-Person
Virtual
Hybrid
Name of Venue
Type of Venue
Venue Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Requested Topic/Subject
Length of Time for Presentation
Length of Time for Q & A
Time of Ann's Presentation
Additional Information
Type of Program
Keynote Speaker
Panel Discussion
Workshop
Presentation
Staff Training
Webinar
Podcast
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Part 4: Audience Information
Who is Your Audience:
Number of Attendees:
Audience Ethnicity:
What Would You Most Like Your Audience To Experience?
More Information:
Part 5: Marketing
Confirm event manager will send a draft copy of the program during/ immediately after this call. (Confirmed once received)
Yes
No
Social Media Marketing Handles
Who will Market Event?
Where will the Event Be Marketed?
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Part 6: Who Is Responsible for Payment and Transportation of Speaker?
Including Honorarium/Fee, Travel, and Accommadations
Name
First Name
Last Name
Phone Number
-
Area Code
Phone Number
Email
example@example.com
More Information
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Part III: Additional Information Needed
Will you Provide Ann McNeill your Attendance List?
Yes
No
Will Ann be able to bring/market products for sale or upcoming events by Ann McNeill?
Yes
No
Will you supply a booth or display for Ann's products?
Yes
No
Will you provide an assistant for Ann(product table, etc.)?
Yes
No
Will you provide Ann with photos and/or video/audio recordings of the event/activity?
Yes
No
What Meetings and Events Will Ann McNeill Be Expected to attend?
Anything Else We Need to Know to be of Maximum Service to You?
Submit
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