Please note that this is not a contract. This form is required in order to evaluate your request to have our speakers come to your community

GENERAL INFORMATION:
Choose a Speaker:
Has a team member appeared for your organization before? Yes No
  If yes, please give ALL prior dates.

Contact Name:
Address:
City:
State:
Zip:
Organization:
Phone:
Fax:
Email
Nearest Major Airport:
  Distance

PREVIOUS EXPERIENCE:
Have you ever promoted or managed another event in the past? Yes No
If yes, please describe the following:  
  Goal / Audience of Event you have promoted in the past
  Size of the Event you held in the past
  Allocated Budget of past Event

PROPOSED EVENT:
Scheduled date(s) of the event:
If scheduling with other schools in your area, travel time between schools cannot be more than 45 minutes. Please check all that apply (Evening events for Pam Stenzel must have a minimum of 500 people attending and be approved by our office)
  School Assemblies
  Music Festival
  Fundraising Banquet
  Peer Mentoring
  Youth Conference
  Parent/Teacher Training
  Adult Conference
  Drama Training
Briefly Desctibe the Following:
  Target Audience:
  Expected Attendance:
  Allocated Budget:
  Promotional Plans for the event:
  Goal / Purpose of the event:
 
Any other comments would help us evaluate this request. Give us as much information as possible to help us understand your event, especially regarding any evening event. What is the purpose, who is the audience, what are you wanting to accomplish, again, what is your VISION?
 
 
Thank you for submitting a vision request. We will review your request and contact you within 3-4 business days. If you do not receive a response within 5 business days please call our offices at 888-978-0108 to ensure receipt of your request. We look forward to partnering with you to bring this message to your community.