Event Sponsor Contact Informaton
*
First & Last Name
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Telephone
*
Type
Home
Cell
Office
*
Email
*
Preferred method of contact
Telephone
Email
Event Information
*
Church, group, business or organization sponsoring this event
*
City
*
ST
Event Location (if different than above)
City
ST
*
What type of event are you planning (retreat, conference, business meeting, training session, luncheon, marriage conference, etc.)
*
Type of audience (women, men, mixed)
*
Expected attendance
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Date of event
(if you have alternate dates to be considered, please specify preference)
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Number of presentations speaker will make during this event
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Speaking Fee Budget
(Please allow for added expenses of travel, meals and lodging, if the event is 1 hour or more from the speaker's residence.)
*
Which CSS Speakers/Communicator(s) are you inquirying about for your event?
(please use a comma to separate names)
*
Indicates Response Required
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