Tinesha Euphemia Booking Form

TINESHA EUPHEMIA MINISTRIES

BOOKING FORM

Name/Name of Church or Organization

Name of Leader/CEO

Address:

E-mail:

example@example.com

Phone Number:

Format: (000) 000-0000.

Type of Service requesting

EVENT SPEAKER DETAILS (if applicable)

Name of Event:

Event Host:

Date of Event:

Date

Hour AM/PM Option

Location of Event:

Street Address

Street Address Line 2

CityCountry

Type of Event:

Theme of Event:

Expected Audience:

How much time does Tinesha Euphemia have to speak?

COUNSELING DETAILS (if applicable)

This booking is for

What services do you wish to avail now?

Preferred date and time for appointment (give options):

What are you primary Concerns/Message (you can share what you feel, symptoms etc.):

EVENT PRODUCTION (if applicable)

This booking is for

What service(s) do you need assistance with?

What are your main requirements/concerns?

TRAVEL & ACCOMODATION (if applicable)

Passport Information will be provided upon request

Name of airline:

Flight Number:

Name of Hotel:

Address of Hotel:

Tinesha Euphemia's hotel confirmation#:

Will Tinesha Euphemia be greeted when she arrives at the airport?

Name of Driver:

Telephone contact for driver:

Please enter a valid phone number.Format: (000) 000-0000.

Distance from airport to hotel:

Distance from hotel to event location:

ADDITIONAL & HONORARIUM INFORMATION

Tinesha Euphemia would prefer fruits and vegetables. She DOES NOT eat red meat. Her choice of beverage would be room temperature water or green tea (no sugar).

Tinesha Euphemia values you and/or your organization. As a result she ensures that at the end of whatever service she provides you receive value that would successfully add to your life and/or your organization.

Tinesha Euphemia does not believe in charging for the work of the Lord so all preaching, mentoring and discipleship are at no cost. Her other honorarium rates are as follow:

Transformational Speaker $300.00 (per hour)
Individual Counseling $85 (50mins)
Couples Counseling $100.00 (50mins)
Event Production $25.00 (per hour)
Consultation $25 (30mins)

Payment Options:

Cash
Bank Transfer:
CIBC First Caribbean International Bank

Savings Account

Name: Tinesha Duncan

Branch: 09706

Account#:201738133
Cheque

All prices are in US Dollars. If you are paying with cheque, please make all cheques payable to Tinesha Duncan.

The above information was completed and accepted by:

Signature

Thank you for considering Tinesha Euphemia to serve you. We will review your request and contact you shortly.