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Pre-Program Action Form

Thank you for supplying the important program details. If you do not know some of the information such as program title or size of audience at this time, please provide that later.

Pam provides a quick meeting planner’s check list to help remind you of any pending details you might need to send at different times during your work with her.

NO NEED TO DUPLICATE INFORMATION HERE

Many meeting planners have forms and letters of agreement that include the information we request in this Action Form. If your forms do not include any of these pieces of information, fill out these sections only.

Contact Information

*Name of Company or Association:
*Website:
*Name:
Title:
*Email:
*Address:
Address 2:
*City:
*State:
*Zip:
*Phone:
Cell:
*Fax:
*Emergency:
Best Time to Call:
Other contacts you'd like me to include (Name, Title, Email, Phone):
Contact information of the person that referred you:

Program Information

*Date: (MM/DD/YYYY)

/ /

Event:

Theme of Event:

Pam's Program(s) you selected:

*Title 1:
*Length:
Time:	to
Expected Audience Size:

Title 2:
Length:
Time:	to
Expected Audience Size:

Title 3:
Length:
Time:	to
Expected Audience Size:

Will you be requiring CEU/CME information?

Yes No

Will you be doing the online participant survey and phone interviews?

Yes No

Date you will have the participant survey returned: (due one-month before program.)

/ / MM/DD/YYYY

Will you be permitting Pam to do 12-minute phone interviews with some of your colleagues?

Yes No

Date you will have interviewee names to Pam: (due a minimum of one month before program.)

/ / MM/DD/YYYY

Will you be able to send us a copy of any promotional pieces you send out before the program?

Yes No

Program Materials

Will you want handouts for your program?

Yes No

What is your preferred format for handouts?

	A paper copy of the PowerPoint presentation slides with slide(s) on each page. I will send the master to you for duplication.
	An electronic copy of the PowerPoint that we will post on our server for participants to download before the program.
	An electronic copy of the PowerPoint that we will post on our server for participants to download after the program.
	Other

Do you have any due-dates for handouts?

Will you be able to reproduce the handouts?

Yes No

Will you be able to put Pam's presentation on a secure website page after the program?

Yes No

Meeting Logistics

*Location:
Contact Person:
Website:
*Address:
Address 2:
*City:
*State:
*Zip:
Room:
Phone Number:
Expected Room Arrangement:

Is the room arrangement negotiable?
Yes No

Arrival
Pam likes to arrive at least an hour before the program. What time can she arrive to the first program?


Will the audience be eating a meal during the program?
Yes No

Pre- and Post- Program Events
Pam does not believe in rushing through her time with you, so please feel free to let her know your wishes for her stay with you and she will do everything possible to satisfy your requests.
What are the times and places of any pre-event receptions, etc?


What other events would you like Pam to possibly attend (time permitting)?


What is the attire?


Pam likes to arrive the night before. Do you have any requests for meeting anyone or making any introductions?


Audio-visual
Next to your work with Pam, she feels strongly that the audio-visual support staff is very important to a smooth running event. She wants to meet with them at least 30 minutes before her program.
Will there be someone on site?	Yes No

Who is the contact person if known?
Name:
Email:
Phone Number:

*What audio-visuals will you provide?


Do you intend to tape the session?	Yes No

Introduction
Pam likes the person introducing her to feel as comfortable as possible. She will have a short conversation with this person and a couple of suggestions for the introducer to insure that goal is accomplished.
Who will be introducing Pam?
Name:
Email:
Phone Number:

Product

Pam does not sell her product during her program. Product purchase is purely optional.
Do you want Pam to make cds, organizing files, books available to participants?
Yes No

Do you want attendance gifts? Which and how many would you like?
CD
Book

Would you like to purchase CDs or books for participants?
Yes No

Travel

All flights are booked coach. If your event is part of a multiple-leg event, Pam guarantees that your cost is pro-rated. You have the option to request she purchase a refundable ticket. If you need to make changes to your event date, cost to re-ticket will be part of your travel expenses.

Is it agreeable to let Pam's office make the travel arrangements?

Yes No

If not, what procedure would you like for travel arrangements?

What is the nearest airport?

Will someone be picking Pam up at the airport? If so, what is their contact information?

What means of ground transportation, if any, is necessary during the course of Pam's stay?

Unless otherwise instructed, Pam will take a cab or car to your meeting location.

Lodging

Pam wants to be well-rested for you and your colleagues. Her only requests are a non-smoking room at a good distance from elevators and/or vending and ice machines.
Hotel Name:
Hotel Website:
Hotel Phone:
Hotel Address:
Hotel Distance from Airport:
Confirmation Number:
Billing information: (Client or Designs on Time?)

Invoicing

Who should receive the invoice?
What is that person's email address?

Other

If anything has been forgotten that you know will insure an exceptional experience for your meeting, please let Pam know here or call her at 314.832.7056.
Other Information:

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