Kevin and Jackie Freiberg

	Kevin’s Event Materials
	Jackie’s Event Materials
	Kevin & Jackie’s Event Materials
		Bio
		Introduction
		Pre-Program Questionnaire
		Publicity Photographs
		Room and A/V Needs

Free E-zine and Audio Program

This one-hour audio program will help you recruit, hire and retain people with the right attitudes and skill.

Sign me up!

Help the Freibergs hit a home run at your meeting by completing the following form.

Date of Event:
Name of Organization or Meeting:
How did you hear about the Freibergs?
Why did you choose them for this event?

Note: If the audience members are not a part of your organization, please answer the following questions from the viewpoint of the audience.


1.	What type of meeting is it?
	Annual Meeting
	Quarterly Meeting
	Award/recognition Event
	Other:
	What is your specific objective for the overall meeting?
	What is the theme of your conference or meeting?
2.	What are your specific objectives for the Freibergs’ session? What would you like the audience to walk away with?
	A.
	B.
	C.
3.	What speakers has your audience heard in the past?
	Name	Topic
	Name	Topic
	Name	Topic
4.	What have you appreciated about speakers you have heard in the past?
5.	What have you disliked about speakers you have heard in the past?


6.	What major products and/or services does your organization provide?
7.	What clients or customers do you serve?
8.	Who are your major competitors or threats?
9.	What major changes or challenges face your industry and organization?


10.	How many people will be attending the Freibergs’ presentation?
11.	What is the percentage of men & women in the audience?
	Men	Women
12.	What is the average age of the audience? Age range?
13.	The majority of the audience will have how many years of experience in the industry?
14.	What are the major responsibilities of audience members?
15.	The Freibergs would like to have a 20-30 minute research phone call in preparation for this event. Who would be the most informed person for this call?
	Name	Title
	Organization
	Phone	Fax
	E-mail address
16.	In addition, please identify three movers and shakers in your organization who will be in the audience. With your permission, the Freibergs would like to send them three to five questions for research and customizing information.
	Name
	Organization
	E-mail address

	Name
	Organization
	E-mail address

	Name
	Organization
	E-mail address


17.	What takes place immediately before the Freibergs’ program?
18.	Starting time:
	Entire program	The Freibergs’ presentation
19.	Ending time:
	Entire program	The Freibergs’ presentation
20.	What takes place immediately after the Freibergs’ program? Please provide an agenda for the day the Freibergs speak & for the overall program.
21.	Person introducing the Freibergs?
	Phone	Fax
22.	Person responsible for a/v set up? Phone
23.	Will an AV technician be on-site?
	If so, please provide:
	Company Name
	Contact Person
	Phone	Fax
	E-mail address
24.	When will the meeting room & AV tech be available for the Freibergs’ AV check?
	Date	Time


	Audio or video recording of the presentation in part or whole for anything other than archival use is not a part of our agreement. Should such a program reproduction and usage be desired, we will be pleased to provide a separate quotation. If you are audio or video recording for archival purposes please provide us with a digital master copy of the tape within 14 days after your event.
25.	Will the program be:
	Purpose:
	If taped, by whom?
	Phone	Fax
	E-mail address

	The Freibergs request a banquet table just outside the meeting room where they can offer learning resources, products, and a free handout. Attendees love taking an experience of the message home with them. The Freibergs DO NOT sell anything from the podium (we hate that stuff).
26.	Person responsible for room set up
	Phone

27.	Where will the event be held?
	Location
	Address
	City
	State	Zip
	Phone	Fax
	Meeting Room
28.	Nearest major airport to arrive at?
	Distance to the meeting site
	in terms of miles?	time?
29.	Where have you reserved a room for the Freibergs? (non-smoking room/king-size bed)
	Hotel
	Address
	City
	State	Zip
	Phone	Fax
	Reservation confirmation number
30.	For transportation between the airport and meeting site, the Freibergs require a sedan and driver. Please make these arrangements and send us:
	Name of Company
	Contact Information (800#)
	Where will the Freibergs be met?
	Pickup location for return to airport
	Time of pickup
	Confirmation number:
	Inbound trip
	Oubound trip
31.	In case of an emergency, who should the Freibergs contact?
	Business Phone:	Home Phone:
	Cellular Phone:	Pager:


Name:
Title:
Company:
Address:
City, State, Zip:
Telephone:
Fax:
E-mail:
Web Site:


When you have finished filling out this form, press this button to send it to us!