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Pre-program Questionnaire

Your Email *

Your Name *

Event Title

Organization

Event Day

Event time


The Program

1. What is the conference/meeting theme?

2. What is the specific purpose of this meeting?

3. What are your specific objectives for this event?

4. What takes place immediately before and after Nicks’ presentation?

Before:
After:

Who will introduce Nick?

Time of presentation
Start:
End:
Length of Q&A (included in above times)

6. Are you planning to audio and/or video the presentation?

 Audio Video Audio & Video

What will the audio or video material be used for?

*** Please remember, you must receive written permission from us to do so.

Are you requesting permission now or have you already done so?

7. Which speakers have you used in the past for a similar event?

8. With your permission, we would like two contact persons Nick can personally speak to for more information.

Name:
Title:
Phone:
Cell:

Name:
Title:
Phone:
Cell:


Audience Information

1. Number of attendees?
Are spouses invited?
Percentage male/female?
Average age
Ethnic make-up? Ethnic make-up?

2. Who will be attending this event?

3. What are the names and titles of your top executives who will be at the meeting?

4. Is there anything Nick should know about the audience before addressing them?


General Background Information

1. What is the purpose/mission of your organization?

2. Is there a shared concern by the audience and, if so, what is it?

3. What is the greatest challenge they are currently facing?

4. What are the most significant events that have occurred in your industry, organization or group during the past year?


Additional Information

1. Contact person at the event?

Name:
Phone:
Work Phone:
Cellphone:

2. If there is an emergency during traveling, who should be contacted?

Name:
Phone:
Work Phone:
Cellphone:

Emergency Back-up:

3. Event location:

Address:

Phone:
Fax:
Event room:
Distance from hotel:
Distance from airport:

4. Audio/visual requirements confirmed:

5. Hotel where Nick will be staying (if different from above).

Address:
Phone:
Fax:
Distance from airport:
Confirmation #

Person picking up and returning Nick to airport (if required):

Company:
Name:
Phone:
Cellphone:
Will driver meet Nick at the Baggage Claim? Or Curbside?


Product

Nick has product he would like to make available for your audience after his presentation. Nick will be happy to autograph and personalize the product. May he be permitted to sell products?

If yes, we can arrange this in two ways. Which do you prefer?
 A. Group purchase in advance for each attendee at discount price. B. Materials made available outside meeting room after presentation.

If A, an invoice would be sent to you. Only additional charges would be shipping
If B, please make sure that:

Nothing will be happening after presentation for at least 15 minutes
A table and chairs will be made available outside the meeting room
Someone from your group will be available to assist speaker

Location to ship product, if applicable:

ATTN:
Address:
Phone:
Cellphone:
Fax:

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Nick Ugoalah is a gold medal wrestler, entrepreneur, Chief of a village and a former foster child. He is the founder of UGO High Performance, a company committed to developing high performing leaders, organizations and teams.

 

He now travels worldwide inspiring others to excellence. Nick is a certified executive coach, and holds a BSc from Brock University and an MBA from Royal Roads University.

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Contact
  • 604-787-2608
  • nick@ugohp.com

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