Pre-Conference Questionnaire
Name of organization
Conference theme or name of your conference
Date Of Conference
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Month
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Day
Year
Date
Start time of conference the day of the keynote
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Hour
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Minutes
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PM
AM/PM Option
Ideal time for Adrienne to run a sound check
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Hour
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Minutes
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AM/PM Option
Start time of Adrienne's keynote (Please note: Adrienne's keynotes run 60 minutes unless other arrangements have been made)
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Hour
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10
20
30
40
50
Minutes
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PM
AM/PM Option
What is your organization's and/or conference's social media handles and hashtags so we may tag you in hype posts pre and post conference? (please include all social platforms that are applicable)
i.e. Twitter = @adriennebulinsk
Adrienne's on site contact person
First Name
Last Name
Cell Number
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Area Code
Phone Number
Email
example@example.com
Number of conference attendees
In a few sentences please describe the “personality” of the audience:
What organizations/schools have been invited to attend the conference:
What is the dress code for your event?
It is not uncommon audiences members want to visit with Adrienne after her program. We ask that your organization have a representative with Adrienne until she leaves the building. Who will that representative be? Please list their name, email, cell, and role within your organization.
Where will the keynote be taking place? i.e. in an auditorium, ballroom, gym, etc.
Will there be a dedicated AV person on site? Please provide their name and email:
Will there be a professional photographer or videographer on site?
photographer
videographer
None of the above
Would your organization like to purchase any of Adrienne's books for the attendees?
Yes
No
Would your organization like Adrienne to have books available for purchase?
Yes
No
Would your organization like a press release about Adrienne’s visit (for use on your website, blog, social media announcements, etc.)?
Yes
No
Where should the press release be sent?
example@example.com
Do you have any questions or further comments for Adrienne?
Submit
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