Speechwriter's Speech Evaluation Form

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Customer/Writer
Speech/Event Information Form
Warren H. (Sandy) Anderson

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

Purpose: 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, we will exchange E-mails or 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.

Answer What You Can: 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 E-mail, by phone or in a face-to-face meeting, if that is better for you or your company.

(Fields with asterisk * are required)

At a minimum, I need your FULL NAME, Telephone and Email address to be able to assist you.

Section I: Information About The Speaker

Speaker's Name *     Speaker's Title

Speaker's Business Name (Name of main organization with which they are associated)

Address (Line 1)

Address (Line 2)

City State Zip Code

Phone *     Fax Cell Phone

E-Mail *

Section II: Event, Time, & Location
(Describe the setting for the speech and a few details about it.)

Event Title

Event Venue (Name of Hotel, Building or Structure at the event site)

Event Section Name (Room Name, Booth or Section)

Event Date Event Time

Event Street Address

City State Zip Code

Speech Start Time Speech Target Length (in minutes)

Person introducing the speaker

Section III: (Fill-in only if speaker is representing a company or corporation)
(The main person for us to communicate with regarding this speech.)

Primary Contact's Name (e.g.: Assistant to:) Title

Company

Phone     Fax     Cell Phone

E-Mail Department

Best time to reach the Primary Contact (Days and Hours)

Section IV: Audience Analysis

Anticipated or estimated number of people that might attend the event

Audience Description: Describe the audience. e.g. What brings them together? What commonalties do they have? Example: All students, Average Age, Gender, 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 V: Event Agenda
What will the Audience be doing before and after the speech? (For example: Let me know if your speech is part of a multi-day seminar. Let me know if your speech follows cocktails or other entertainment. e.g. 7:00 to 7:30 Cocktails. SPEECH. 8:00 to 9:30 dinner.)

Audience Activities Before the SPEECH
From:     To:     Activity:

From:     To:     Activity:

From:     To:     Activity:

From:     To:     Activity:

Audience Activities After the SPEECH

From:     To:     Activity:

From:     To:     Activity:

From:     To:     Activity:

Section VI: Additional Contacts
Let me know if I need to speak with or work with anyone else other than the Primary Contact in order to develop the Speech.

Name     Phone:
Resource Information:

Name     Phone:
Resource Information:

Section VII: SPEECH Details
Identify the topic of the desired speech and any guidelines that need to be incorporated. Any details you can specify will help create a better customized speech.

What is the central idea or objective of the speech?

What is the next important idea or theme of the speech (If none; say none)?

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, quip or starting statement that might get your audience's attention?

Major Points:
Most of the time I will work with the Primary Contact on some of the key points by phone or I will produce them unassisted. If you have some specific points you want covered in the speech, list them here. If necessary, we'll discuss them over the phone.

Point #1

Point #2

Point #3

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

Specify the use of Audio Visual materials:
The Speaker will not be using Audio Visual materials of any kind.
The Speaker will be using Audio Visual materials of their own or supplied by a third party.
The Speaker would like me to produce an Audio Visual Microsoft PowerPoint presentation *.
* I design professionally attractive bullets, charts, graphs and pictures to support the text I prepare.

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