Team Builders, Inc wants to make every effort to create a relevant presentation. Please fill out the form below which will help us understand your needs and allow us to formulate the best experience for your audience.

Name:
Company:
Email Address:
Street Address:
City:
State: Province:
Zip/Postal Code:
Country:
Phone:
Fax:
I plan to have a program within the next:
	Help! I need someone right away.
	6 months
	9 months
	1 year
	Unknown - please send information
Where is the meeting taking place?
What is the purpose of the meeting?
What is the theme?
Who is the target audience?
Audience Size:
What ideas are you trying to sell to those at your meeting?
What are the decision maker's major hopes for this meeting?
Please tell us about your organization:
What is the mission of this organization?
What is the organization's competitive position?
What are the three biggest challenges facing the industry now?
What are the difficulties and challenges facing the organization now?
What sense of urgency do you feel about improving matters?
What opportunities are waiting to be exploited?
What are the audience demographics?
Percent Male:
Percent Female:
Age Range:
Education:
Past Speakers:
Do you want to follow the same criteria as last year or differently and if so, what?
What is the low end of a speaker's fee and high end of speaker's fee?
Low:
High:
What other speakers are you considering and why do you like them?
When do you need this information?
What is your deadline for selecting speakers?
Who will make the decisions?
How may we contact you?
Comments: