Submitted by developer on Thu, 2016-05-19 15:23 First Name * Last Name * Company/Affiliation * Position * Phone Number * Email Address * Address * Website Event Name * Event Location * Event Date * Year Year202120222023 Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Event Time(s) * Event Type * Event Website/Facebook Estimated Attendance * People Audience Type * - Select -Men’s MinistryChurch CongregationNonbelieversWomen’s Group'Car Guys'Other Other Audience Type Speaker Type * - Select -KeynoteModeratorPanelistPresenterOther Other Speaker Type Length of Presentation * Proposed subject matter * Are there multiple events? (i.e.: Car show Saturday, Church service Sunday) * yes no If audio/visual is used, is the sponsor capable of making arrangements? * yes no A/V contact (if applicable) Are you willing to pay for travel? * yes no Is there an honorarium? * yes no Additional comments/notes