Reconnection starts here.

-Chip Neuenschwander

Pre-Program Information

Thank you for agreeing to engage Chip for your upcoming program! We’re excited to collaborate and provide an experience tailored specifically for your group. To help Chip understand your unique needs and ensure the presentation is meaningful and impactful, please take a few moments to complete this form.

If any prompts do not apply to you, you can leave them blank. However, any information you provide can be helpful in understanding your audience’s unique needs. Thank you and we look forward to serving you!

Organization Name

Contact Name

First Name

Last Name

Phone Number

Emergency Contacts

In case of an emergency or problem immediately before the event, include the name and number of any additional contacts you would like to add.

Presentation Date & Time

Length of Presentation

Expected attendance

Is there a theme for the event?

What will be taking place immediately before/after our program?

Unique features of your organization

Are there key people in the audience to be aware of?

What is the composition of the audience?

What do you want to accomplish in this meeting?

Share three concerns/problems/challenges facing your group.

Any sensitive areas to be avoided?

In case of an emergency during the program, here's the desired response:

What else should I know about your organization that would make this program more meaningful?

How will you know this program succeeded for you? What would a win look like?

Is there anything we should have asked but didn't?

Consent & Collaboration

I understand that there may be follow-up communication to clarify details if necessary, and I welcome collaboration to ensure a successful event. I also agree to follow up with Chip if there are any significant changes before the event.

Agree

Decline