Scheduling Request

1

Thank you for your interest in scheduling a WallBuilders' speaker for your event. We typically schedule a speaker 6-9 months in advance of an event.

Due to the volume of requests received, it may take several weeks to up to two months (or longer) to provide an update on speaker availability and confirm your event.

Please keep this in mind when asking for a deadline for response. While we will make every effort to respond as quickly as possible, we appreciate your understanding and patience during this process.

2

Is this your group's first time to request a WallBuilders Speaker?* This field is required.

YesNo

3

Type of Event* This field is required.

4

Your Speaker Preference* This field is required.Who would be your first choice for a speaker?

Tim Barton

David Barton

5

David Barton's honorarium is $6,000

YesNo

6

Tim Barton's honorarium is $4,000

YesNo

7

Rene Diaz's honorarium is $2,000

YesNo

8

Matt Krause's honorarium is $2,000

YesNo

9

If your preferred speaker is not available, would you like us to transfer your request to another of WallBuilders' speakers?

YesNo

10

Event sponsor agrees to pay the travel expense by the due date given in the contract. These expenses are billed at a flat rate, and include all applicable airfare, lodging, transportation, food, tolls/tips/misc. WallBuilder Presentations reserves the right to cancel participation if payment is not received by the requested date.* This field is required.

I acceptI don’t accept

11

The Event Sponsor is aware that an honorarium is required in addition to the travel expense.* This field is required.

I acceptI don’t accept

12

Is this event a multi-day event where the WallBuilders Speaker will speak more than one day?* This field is required.Please note: The honorarium increases by 50% for every additional day our speakers are presenting Travel fees may also be increased to cover additional days

YesNo

13

Event Date* This field is required.

mm-dd-yyyy

14

Event Time* This field is required.

15

Event Start Date* This field is required.

mm-dd-yyyy

16

Event Start Time* This field is required.

17

Event End Date* This field is required.

mm-dd-yyyy

18

Event End Time* This field is required.

19

Speaker Involvement* This field is required.What do you envision the speaker doing for your event?

20

Other ParticipantsPlease list any VIP's or Individuals the speaker might want to know will be present at your event

21

Name of Venue* This field is required.Please tell us the name of the place where the event will be held.

22

Event Address

Address

City/Town

State/Region/Province

Zip/Post Code

Country

23

Expected Attendance* This field is required.

24

Description of Audience* This field is required.

25

CommentsAnything else we should know?

26

Your Name* This field is required.

First Name

Last Name

27

Are you a Pastor?* This field is required.

PastorNot a Pastor

28

Your Phone Number* This field is required.

Please enter a valid phone number

29

Your Email* This field is required.

example@example.com

30

Would you like to receive email updates and newsletters from WallBuilders?

YesNo

31

How did you hear about us?* This field is required.

32

Organization Name* This field is required.

33

Organization Website* This field is required.

34

Is this a Church or Ministry?* This field is required.

YesNo

35

Are you in the Leadership role in your Organization for this event?* This field is required.

YesNo

36

Leader's Full Name* This field is required.

First Name

Last Name

37

Leader's Phone Number* This field is required.

Please enter a valid phone number

38

Leader's Email* This field is required.

example@example.com

39

Data Source

Events

40

Is this leader a pastor?* This field is required.

PastorNot a Pastor

41

Event Dates (Multiple)

42

Event Times (Multiple)