Form

A.M.P. Keynote Assessment

Authenticity • Mindset • Performance | This short assessment helps ensure the keynote fits the reality you’re navigating — not a generic template.
Context

Help me understand the setting and people involved so the keynote matches the moment.
Organization / Group Name*
Primary Contact*

First NameLast Name
Email*
example@example.com
Location*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Role / Title*
Audience
Estimated Audience*

Under 2525 - 5050 - 100100 +
Audience Type*

Executive / senior decision-makersManagers / SupervisorsMixed rolesOther
If you selected “Other,” please briefly describe the audience
Example: frontline staff, technical team, athletes, educators, mixed non-leadership roles
Pressure & Reality

This is where your work is different.
Which best describes the environment your people are operating in right now?Checkboxes (select up to 3)*

High pressure / high expectationsRapid change or uncertaintyBurnout or mental fatigueAccountability without clarityStrong performance, fragile moraleTransition or growth phase
Where do you most notice pressure showing up?*
(Decision-making, communication, reactions, consistency, confidence, trust, etc.)
What you're hoping to shift
If this keynote does its job, what would be different afterward?*
Which areas matter most right now?Checkboxes (select up to 3)*

Clearer decision-making under pressureEmotional control and composureConfidence without egoConsistency in performanceTrust and accountabilityPersonal responsibility
Fit & Expectations
What attracted you to this keynote?*
What do you want this keynote to avoid?*

Corporate jargonHype or “rah-rah” motivationGeneric leadership adviceOne-size-fits-all messaging
Preferred keynote length*

45-60 minutes75-90 minutesOpen to recommendation
Logistics
Tentative event date or timeframe*
Location*

In-personVirtual
Comments about location
This keynote investment typically starts at $5,000. Which best reflects your current position?*

YES - this fits our budgetPossibly - it depends on scope, format, or customizationNO - this is outside our current range
Final Insight
Anything else you feel is important for me to know?
Should be Empty:

A.M.P. Keynote Assessment

Context

Audience

Pressure & Reality

What you're hoping to shift

Fit & Expectations

Logistics

Final Insight