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Customer/Writer
Speech/Event Information Form

Warren H. (Sandy) Anderson

Executive Speech & Business Writing (Tel: 704 365-3004)

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The purpose of this form is to gather as much information as possible about your speech event so that I can write the best speech possible at the least cost to you.  Please relax. This form is just a place to get started.  In almost every case, I will interview you by phone call to get the details I will need. This form just gives me a good grasp of the full engagement so I can help you focus your thoughts in our phone conversation. If you don't mind, I'll record our phone conversation.

While I'd appreciate it if you would try to supply as many details as possible, I recognize that, in many cases, you may not know some information or not have an opinion and that's OK. Just answer "none" or leave it blank. We can work out the details by phone or in a face-to-face meeting, if that is better for you or your company.

 

Section I: Information on Speaker (Name, Home/business Address and

Your name or the name of the Speaker:                   
   

Address of Speaker (Home if Representing Self) ( Or Business if Representing Company)

City                                                     State                    Zip
              

Your Telephone number:      Your fax number                         Work Number
  

Your E-mail address                                Cell Phone/beeper   
             

Section II: Event, Time, Location (What is the setting for the speech and a few specifics about it.)

Event Title                           

Place of speech (e.g. Hotel)

Name room (if known)        

Address of  speech location                              City:                 State                Zip
     

Speech Date   Speech Time    
 
Speech length (min)

Person  introducing speaker (if known)  

Section III: Audience Analysis

How many do you think will be in the audience.   
 (Number of people)   

Audience Description: Do your best to describe the audience, e.g. what got them together, what commonalties do they have (for example: all students; (average age) (sex) etc.  Are all members part of an organization? And you might include information about issues wherein the members of the audience support or disagree with you or with your sponsoring organization.

Section IV: Sequence of Events of Full Occasion -- What has the Audience been doing before the speech and what will it be doing after the speech? (For example if your speech is part of three-day seminar, I should know that and for an after dinner speech you might enter: 7:00 to  7:30 cocktails or 8:00 to 9:30 dinner etc).

Audience Activities Before speech

-- What has the Audience been doing before the speech and what will it be doing after the speech? (For example if your speech is part of three-day seminar, I should know that and for an after dinner speech you might enter: 7:00 to  7:30 cocktails or 8:00 to 9:30 dinner etc).

Audience Activities Before speech

From: To: Activity:

From: To: Activity:

From: To: Activity:

Audience Activities After speech

From: To: Activity:

From: To: Activity:

Section V: Contacts: (Is there anyone in the organization to whom you are speaking, whom I can contact to get details about your speaking event.   Is there anyone on your staff with whom you wish me to work to develop your speech?)

Name:     Org:        Tel:

Name:     Org:         Tel:

Name:     Org:         Tel:

Name:     Org:          Tel:

Section VI: Directed or Deduced Subject/Theme of Speech (For example, what guidance was given you by the program chairman or person who invited you to speak about the subject of the speech or what guidance do you want to give me about the topic or theme of the speech. Here again, if you're not sure, just leave it blank.)

What would be the central idea or objective of the speech? (If you're not sure, we'll work it out by  phone):

What would be a secondary idea or objective of the speech? (If none, that's fine):

To state the above in another way, what do you want your audience to do or think as a result of hearing your speech? (If none, just answer "none"):

Do you know of any quick, funny remark or quip or startling statement that might get your audience's attention? (If you can't think of one, just answer "none")

Section VII: Major Points - Most of the time I will work with you on some of the key points by phone, or I will figure them out for myself. But if you know of some specific points you want to make in the speech, list them here and then we can talk about it on the phone. 

Point #1

Point #2 

Point #3

Point #4 (Plus any other points you may want to add)

Section VIII: Audio Visuals If you have slides or want slides made by me for your speech in either Microsoft PowerPoint or Corel (WordPerfect Presentations) I can design my own point/bullet slides, charts, graphs and pictures for the text I prepare. But if you have pictures or slides you specifically want included you may list them here if you wish to. If you have slides or want slides made by me for your speech in either Microsoft PowerPoint or Corel (WordPerfect Presentations) I can design my own point/bullet slides, charts, graphs and pictures for the text I prepare. But if you have pictures or slides you specifically want included you may list them here if you wish to.

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