EVENT INTAKE FORM
Please complete and return to:
booking@kentjulian.com
fax: 678-487-8654
Live It Forward LLC  1032 Old Peachtree Road NW, Suite 401-184  Lawrenceville, GA 30043
Contact Person
Organization’s Name
Organization’s Address
Contact Person for this Event
Office Phone
Cell Phone
Title
Email
Fax
NOTE: Kent will use the cell phone listed above during his travel to your event.
NOTE: To contact Kent during his travel to your event, please call 404-272-4527.
Travel
1.
What are the airports for Kent to consider when flying to this event?
Is there one airport that you would recommend over the others?
NOTE: Kent flies from the Atlanta International Airport via Delta Airlines
2.
Will someone pick Kent up from the airport or would you rather have him rent a car or take
a taxi?
3.
The only travel expense your organization is contractually required to arrange and cover is
lodging.
What is the name, phone number, and address of where Kent will be staying?
What is the confirmation number for his room?
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Shipping
1.
If we decide to ship product, where is the best place to send it?
Your Organization, Event Conference Center, or Hotel?
Shipping Address
Attention (person or department)
2.
Ideal arrival date of packages?
Event Logistics
1.
Where will Kent be speaking?
Exact name of the location where Kent will be presenting:
Complete address of the location where Kent will be presenting:
Phone number of the location where Kent will be presenting:
2.
What are the dates of your entire event?
Date and time of Opening Session?
Date and time of Closing Session?
Date(s) Kent needs to be at the event?
Webpage with event details (i.e. theme, schedule, etc.)?
3.
Is there a dress code or guidelines for appropriate attire?
4.
Time frame of Kent’s session(s)?
Session One:
Date
Start Time
End Time
Amount of time allotted for Kent’s presentation
Session Two:
Date
Start Time
End Time
Amount of time allotted for Kent’s presentation
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Session Three:
Date
Start Time
End Time
Amount of time allotted for Kent’s presentation
Session Four:
Date
Start Time
End Time
Amount of time allotted for Kent’s presentation
The Audience
1.
Number attending
2.
Range of age
3.
Average age of group
4.
Percentage of males
5.
Educational background
6.
What are the major roles and/or responsibilities of the audience?
to
Percentage of females
Creating a Winning Program
1.
What is the theme of your event?
2.
Imagine you have a blank sheet of paper and you could create an ideal conference by just
writing words. What would you write? What are 2-3 big goals you want to achieve during
your entire event to empower your attendees to SHOW UP AND SHINE?
3.
What is the specific purpose of the session(s) at which you are asking Kent to present
(training, competition, awards, annual meeting, etc.)?
What specific outcomes do you want Kent to achieve with his presentation(s) that will
assist you in achieving your SHOW UP AND SHINE goals for your event?
Are there any sensitive issues that should be avoided?
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3.
Are there any specific problems or challenges your organization is facing that you want
Kent to address if it fits into his presentation(s)?
4.
Are there any positive opportunities your organization is experiencing (or close to
experiencing) that you want Kent to address if it fits into his presentation(s)?
5.
What specific characteristics/behaviors are you looking to champion with your members?
In other words, what characteristics/behaviors separate your SHOW UP AND SHINE
people from others in your organization?
6.
Any other suggestions to help Kent make this program your best ever?
Thank you for sharing your responses on this Intake Form. This
information will help Kent design programs that fit your event
goals and desires!
Please complete and return to:
booking@KentJulian.com
fax: 678-487-8654
Live It Forward LLC  1032 Old Peachtree Road NW, Suite 401-184  Lawrenceville, GA 30043
www.KentJulian.com
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