The Safety
Pre-Meeting Questionnaire

The following questions are designed to personalize each presentation to the audience’s and organization’s needs. Please take a few moments to answer the questions below and return this questionnaire. Thank you for your help! 

Contact Information

Speaking Topic: Date:
Meeting Coordinator:  
Daytime Phone: E-mail:
How did you hear about Dr. Perry?

Presentation Content

What is the purpose/theme of the event? (awards banquet, annual meeting, trade convention, etc.)?


What are the exact times of the presentation?


What is the expected length of the presentation?


What is happening immediately before Dr. Perry’s presentation?


What is happening immediately after Dr. Perry’s presentation?


What is the best time for Dr. Perry to do her a/v room check?


What is the proper attire Dr. Perry?(Please circle one) 
Business Suit Black Tie Casual
What is Dr. Perry’s role in the program (opening or closing keynote, luncheon, etc.)?
Who will be introducing Dr. Perry?
What percentage entertainment vs. high content techniques and strategies would you like?

% entertainment

% high content

What are your objectives for our session?


Are there any issues or topics in particular that you think we should discuss in this program?


What “local color” can you think of relating to the location or the organization (i.e. are there frequent floods? Did the local mayor just get arrested? etc.)


Is there good news/bad news about your organization that I should/should not include in the presentation?


Is there a slogan or philosophy that is commonly used in your organization?


Is there any industry jargon that Dr. Perry should be aware of?


Who are three people in your organization who are well-known and well like within in the group, who will be present and who we can “pick on” (in fun) if the appropriate situation arises.


When your people depart from this presentations, what ONE thing do you want to be uppermost in their minds?


Who are the other professional speakers on this program?
 Role in Program:
 Role in Program:
 Role in Program:
What other professional speakers you have used in the past? What did you like about their performance?



What is the nearest major airport to the meeting site?


For transportation to and from the airport would you prefer: (Please circle one)
To meet Dr. Perry at the airport or

To have Dr. Perry take a cab

Where is the exact location of the meeting?


What hotel will Dr. Perry be staying, if not the same location as the meeting?


How far is this hotel from the meeting location?


In case of emergency or flight delays who and where should Dr. Perry contact?



Number of Attendees

Average Age

% Male

% Female

What type of people will be attending this presentation?


% of executives

% of manager

% of employees

Should the message be targeted more to one group that the other?


What do you consider the primary strengths of your organization?


What are your organizations concerns and fears?


What are some of your organizations victories?


What are some current problems experienced by your industry/organization?


What are the most significant events that have occurred in your industry/organization in the past year?


Do you have any other suggestions to help make this program your best ever?


Additional Information

Please send the following information as soon as possible:

Ë    The agenda of the meeting/conference

Ë    Information about the company/organization (history of the organization, corporate report, publications, newsletters, etc.)

After we have received your instructions, we would like a telephone appointment. 

What are the names of three people valuable for Dr. Perry to interview so we can customize your presentation?

Name Title
Phone Fax E-mail
Name Title
Phone Fax E-mail
Name Title
Phone Fax E-mail

Please send all correspondence to: 

Dr. Isabel Perry

5019 Winwood Way

Orlando, FL 32819-3303 USA

Fax : 407-291-7499


For more information about Dr. Perry please call
407-291-1209, Inc
Orlando, FL 32819-3303
Phone: 407-291-1209
Fax: 407-291-7499
[email protected]