CHURCH/ORGANIZATION:

ADDRESS:

CONTACT PERSON:

EMAIL ADDRESS:

PHONE NUMBER:

HOW DID YOU HEAR ABOUT MBS REFORMERS?

DATE OF EVENT:

EVENT LOCATION:

THEME:

EVENT AUDIENCE:

YOUTHADULTSBOTH

WHAT DATE(S) AND TIME(S) DO YOU WANT MS. OSORIO-CAMPBELL TO SPEAK?

WHAT MEDIA CAPABILITIES ARE AVAILABLE? (AUDIO, VIDEO, ETC)

WHAT IS THE BUDGETED SPEAKERS HONORARIUM FOR THIS EVENT?

NEAREST AIRPORT:

WHAT IS THE DISTANCE FROM AIRPORT TO EVENT?

WHAT IS THE TIME/DISTANCE FROM HOTEL TO EVENT?

WHAT IS THE ESTIMATED NUMBER OF ATTENDEES?