Name of Church or Organization

Name (Point of Contact)

First Name

Last Name

Email Address

Booking for:

Date of Event

Please indicate the proposed start date of your event

YYYY

Expected Attendance/Audience Size

LOCATION OF EVENT

Country

Province/State

City

Postal/Zip Code

Date of Video Submission (if applicable)

Please enter the date that you would like to receive Cheryl's video submission.

YYYY

Honorarium Amount

Please indicate the amount that you have budgeted for Cheryl's Services

Message

Give a brief description on what the event is about and what you are looking to have Cheryl do at your event

Cheryl's Involvement & Allotted Speaking Time

How many times would you like Cheryl to speak? How long would you like her to speak? When should she plan to arrive and depart?

How did you hear about Cheryl?

Invite Cheryl