Scott’s Pre-Program Questionnaire

This questionnaire is our first step in customization for your event. It ensures that your discussion with Scott will be more productive, thus maximizing the impact of Scott’s program for your audience.

    Client and Event Contact Information













    Program & Schedule








    Audience Demographics

    Approximate # attending meeting:





    Top People to recognize in the audience or people to poke “fun” at:







    Please list the names of two accomplished professionals within the group that Scott
    could call to get additional perspective.








    Organization/Industry














    Local Culture


    Philanthrophy

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