Pre-event Survey
To Make Your Meeting Go
Smoothly *
Your organization/company name:
Contact name:
Phone (include area code and extension):
Email address:
URL for your organization's website:
Date of scheduled event:
Special theme, event, holiday, season or occasion this
meeting is being held:
Audience: (male/female, age range, profession(s),
industries, special need or reason they are here for this meeting, etc.)
Approximately how many people do you expect to attend
this meeting?
Most important thing you want your audience members to
take from this meeting?
Anything special you want audience members to take or feel or be
inspired to do as a result of hearing Jane Hill speak:
Key issues you would like Jane to address:
Do you want a question and answer session after Jane speaks?
What additional information should Jane have about your audience,
your organization or this event?
*There are several ways to
submit your completed form:
-
Type the information into
Jane's Info Request form .
-
Copy and paste the form itself into a Word document,
then type your answers directly into the document. Attach your file to
an email, sending it to the following email address:
-
Or simply fax or mail the form using
the information on Jane's Contact page.
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