Pre-Program Questionnaire

This pre-program questionnaire is to assist Chuck Gallagher, LLC in preparation of Chuck’s presentation to your group. Our objective is to meet your specific needs. In order to do so, we need your help! Please take a few minutes to complete the online form below or download, print and mail in the pre-program questionnaire.

  1. General Information
  2. (required)
  3. (required)
  4. (valid email required)
  5. The Program
  6. Audience Analysis
  7. Spouses attending?
  8. Name the key executives that will be in Chuck’s audience. With your permission, we would like to contact them for more research on your group.
  9. Logistical Information
  10. Will the presentation be taped?
  11. Audio taping?
  12. Video taping?
  13. Exactly where is the meeting?
  14. Emergency contacts

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Download Pre-Program Questionnaire PDF, 247kb