PART 1: Tell us about you and your organization
First Name *
Last Name *
Title / Role
Church or Organization
Website
Street Address *
Address Line 2
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State *
Zip/Postal Code *
Email *
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Mobile Phone
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How'd you hear about Jennifer?
PART 2: Tell us about the speaking opportunity
Speaking Date(s)
Speaking Times
Other Dates You're Considering
Is this event private or public?
Event City
Event Venue
Seating Capacity
Expected Attendance
Nearest Airport
Your budget for honorarium?
Your budget for travel?
Tell us about your previous events
Any additional info you'd like to share with us?
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