Pre-Event Questionnaire

Your Personal Details
Full Name*

First NameLast Name
Title
Organisation or Association Name
E-mail*
Phone Number*

Country CodeArea CodePhone
Postal Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Are you the Event organiser?

YesNo
Will you be the on-site Contact?

YesNo
If there will be a different contact on-site, please also provide us with their contact details.
Event on-site Contact Name

First NameLast Name
Event on-site Contact Mobile

Country CodeArea CodePhone
Event Speaker Budget
Is travel included?

YesNo
What speakers have your organisation or association found valuable in the past? And, what was it about them?
How did you hear about Frederique?
Why did you decide to hire Frederique for your Event?

Your Event Details
Event Name
Event Start Date

MonthDayYear
Event End Date

MonthDayYear
Event Start Time

:HourMinutesAM/PM Option
Event End Time

:HourMinutesAM/PM Option
Event Venue Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Into what airport should we schedule Frederique's flight? 
Hotel Accommodation for Frederique (if different than Event Venue Address) 

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Event Venue Booking Reference/Code
How far is the hotel from the airport? (in km or miles)
How should Frederique travel to the hotel? (cab, car rental, driver pick up…)?
Event Venue Room's Name / #
Event Website
If there is not a dedicated event website, please provide the website, from which you are promoting the event.
Event Hashtag
Frederique LOVES supporting you and your event, as much as she can, so if you have a dedicated hashtag, she will use it in her social media to help you create additional buzz and excitement!
Event Type (annual conference, networking meeting, gala award ceremony, sales kick-off, convention...)
Is the Event organised by a non-profit organisation, or for a charity?

YesNo
If so, for which charity?
Will there be media present at the Event?

YesNo
Event Theme
Why did you choose that theme?
Event Top 3 Objectives

Frederique's Keynote: Lead Beyond The Edge
What is Frederique’s role in your Event (opening or closing keynote, luncheon speaker, breakout…)?
Please upload your Event agenda & schedule, so that Frederique can see how her keynote fits in.

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How long would you like Frederique to speak for?

60min90min120minOther
If other, please specify:
Frederique's Start Time

:HourMinutesAM/PM Option
Frederique's End Time

:HourMinutesAM/PM Option
Who will be introducing Frederique to your group? How should they be addressed? (i.e. First name, Mr Smith…)
What takes place before / after Frederique's keynote? (another speaker, meal, workshop, break, nothing…)
Will there be other speakers at the Event? If so, who are they and what topics will they be addressing?
Would you like Frederique to join your group for any other functions (meals, reception, cocktail party…) before or after her keynote? If yes, please provide details:
What would you like your attendees to get out of Frederique's keynote?
By the end of Frederique’s keynote, what do you want your audience to think, feel, or do differently?

Your Audio Visual Setup
Will you be assisted by an AV Technician?

YesNo
Will you have an LCD projector?

Yes, and we will provide a remote control advancer / clicker.No
What about microphone(s)?

Yes, we will provide a lapel microphone.Not needed considering the room size/acoustic.
If you will be projecting, how many screens will you have?
Please describe screen placement (left, right, center) in regards to the audience.
Will Frederique’s keynote be audio, videotaped or photographed?
Is it possible for a guest of Frederique to attend her keynote?

YesNo

Your Event Layout
Room Layout

Theatre styleClassroom styleCabaret styleBoardroom styleHorseshoe styleOpen Space
Will there be a stage? If yes, please indicate its size and height.
What else will you have? White board, Flipcharts, Podium...

Your Event Promotion
What do you need from us to support your event promotion?

Photos (posed and actions shots)Biographies (several lengths)Website detailsSocial Media channels links (Twitter, LinkedIn, Facebook, Instagram, YouTube, Pinterest)Keynote SynopsisOther
If other, please specify:

Anything else?
What additional information might be helpful for Frederique to know in tailoring her keynote to your event and its audience?
Please upload any additional document you see fit.

Upload a File

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Please upload any additional document you see fit.

Upload a File

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Please upload any additional document you see fit.

Upload a File

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