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Pre-Event Questionnaire

If you would like to have Pat speak to your group or at an event, please tell us about your upcoming program / event and we will get back to you right away.

First Name

Last Name

Company/Organization

Phone

Event Date

Event Start and End Time

Type of Presentation Requested

Keynote
Seminar
Executive Session
Emcee

Event Venue / Location

Event Theme

Closest Airport and Distance to Event Location

What are your specific objectives / results desired for this program/event?

Briefly describe the demographics of the audience (size of group, position of attendees, background, special interests, etc.)?

What will the participants be interested in learning from this session?

What are some challenges faced by the people who will be in the audience?

How did you become aware of Pat B. Freeman?

Additional Comments:

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