speaking request form

Please note: Completing this form is for informational purposes only. By submitting this form, you are requesting that I consider your event, but I am not committing myself to serving your organization. Thanks for your understanding!

Tara's Scheduled Events

PLEASE NOTE: I am NOT available for the following dates:

2010

Jan 29-30: South Carolina
Jan 31: South Carolina
Feb 24-27: Georgia
April 10: Montana
April 17: Iowa
April 30-May 1: Tennessee
Sept 24-25: Ohio
October 1-2: Kansas
October 8-9: Utah

Name:
Address:
Phone Number:
Fax Number:
Email Address:
Best time to contact you:	(your time zone) Eastern Central Mountain Pacific
Event Location: (Venue, City and State)
Event Dates: (Already set or still flexible?)
Event Name:
Host Organization/Church:
Website (if available):
Denomination:
Doctrine/Statement of Faith: (Tell me a little about the host's doctrines/statement of faith)
General Event Description: (goals/purposes, general atmosphere, formal/informal)
Expected Number of Attendees:
Attendee Description: e.g., Christian/non-Christian, mature believers/leaders or seekers, men/women/mixed group
By what date do you need to know whether or not I can speak at your event?
Desired Number and Length of Teaching Sessions:
Financial Considerations: Are you able to cover my expenses? Do you anticipate being able to provide an honorarium? If so, what amount (or range)?
Nearest Airport: What airport will I fly into for your event? And how far away is your event from the airport?
How you heard about me:
Standard or Custom Event: Are you asking for one of my standard events? Or is this a custom event request? If custom, please give details on the topics you'd like me to cover. Please also note that my schedule does not allow me to accept many custom events.
Other Information: Is there anything else I need to know about this event?

You may print this form and mail it to me if you would prefer. Click here for my contact information.