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Needs Assessment Form

Please answer the following Questions thoroughly:

Gathering Date:

Name of Organization:

Event:

Please provide a Brief Profile:

Please Define your Major Objective:

What would it mean to you to realize those objectives?

How would we know if we have succeeded?

Theme of the Meeting?

Audience Demographic?

Size of Audience:

Will there be spouses or significant others in attendance? Y/N

Briefly describe what you have done in the past in this area of growth:

        Who spoke?

        What kind of feedback did you receive?

       

What thoughts would you like conveyed?

What do they expect to learn or walk away with?

Why did you choose Mark?

Location of Event:

Timetable for the talk?

Attire:

Name of person introducing Mark:

Anything else you require?

Name:

Company:

Phone:

email:

 

Please fill out and press

Thank you,

Mark Matteson
mark@mattesonavenue.com