Speaking Assessment

Your Name*

First Last

Phone*

Email*

Event Logistics

Name of the event:*

Brief description/theme of the event*

Objective of the event:

Name of organization sponsoring event:*

Location/Day of Week/Date/Time of event:*

This event is:*

hour(s) event
one-day event
weekend event
one-week event
nonprofit fundraiser

Request for:*

Keynote/Plenary speaker
Panel speaker
Breakout session
Fundraising "Ask"

What is my topic?*

How long should I speak for?*

What is the anticipated size of the audience?

Am I the only speaker at the event?*

Yes
No

How many speakers total will there be?

What will the other speaker topics be?

Where on the agenda will I be speaking?

Can you send me an agenda?*

Yes
No
Not available
When available

Should I send a bio and pic?*

Yes
No
Bio only
Pic only

Is the audience paying to attend?*

Yes
No

What is the cost to attendees?*

What's your budget for the event?

Are travel and accommodations covered?*

Are there networking opportunities before or after the event that I need to plan to attend?*

Yes
No

Event Audience

What is the audience age range? (check all that apply)*

Teens
20's - 30's
30's - 40's
40's - 50's
50's - 60's
mixed

What is the audience gender*

Men
Women
Mixed

Audience Background/Occupations*

How much does the audience know about the topic*

Very Little
Moderate Amount
Have Expertise
Mixed

How do they feel about my topic?*

What is the attire for the event?*

Casual
Business
Formal
Other

May I talk to a few members of the audience before the event to better understand their common need?*

If yes...Contact #1 - name, position, email & phone

If yes...Contact #2 - name, position, email & phone

Speaker Expectations

Why do think I am a good fit to speak to your audience?*

When my presentation is over, what information/feeling/action plan do you want participants to walk away with?*

What is the biggest issue that needs to be addressed in the talk?*

Will there be a Q & A time?*

Yes
No

What kind of questions do you anticipate I will get during the Q & A?

How will questions be facilitated?

What do you not want me to say on stage?

What do you want me to say on stage?

State any jargon or acronyms I should be familiar with

Technology & Set Up

Transporation details*

Uber/Lyft
Rental car
Car service pick up
N/A - Local (Houston area)

Where should I park when I arrive?

Who is my contact when I arrive?*

What time is my sound check?

Who is the stage technician in charge of making sure things go smoothly before and during my speech?

Who will be introducing me?

What will happen before I take stage?

Event welcome
Another speaker
Meal
Activity

What will happen after I take stage?

Another speaker
Meal
Activity
Dismiss audience
Q & A

How will people be sitting?*

At tables
In rows of chairs
At conference table
other

Please check what will be available at the event location (check all that apply)

Wifi
Speakers for sound
Remote Clicker
Laptop
Confidence Monitor

Will there be a podium*

Yes
No

Will I have a microphone?*

Lapel
Hand held
Attached to the podium
None needed

Will there be a screen and projector? (for slides)*

Yes
No

Is the screen...

Square
Wide (16:9) power point
Unsure

Will this event be filmed or recorded?*

Yes, if so I would like the right to use footage
No

Will this event be photographed?*

Yes, if so I would like the right to photos
No

Who do I contact for photos/video?

Event Logistics

Event Audience

Speaker Expectations

Technology & Set Up

Contact

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