Speaker Request Form for Laurie Ford
Who are You Inviting To Speak?
First Name
Last Name
Your Name
*
First Name
Last Name
Your Contact Email
*
example@example.com
Your Contact Phone Number
Format: (000) 000-0000.
Name of Church/Ministry
*
Church or Ministry Website
*
Name of Requested Event or Conference
*
Theme(s) and/or Focus of Gathering
Date of Event
*
/
Month
/
Day
Year
Date
Expected Number of Attendees
*
Event Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Laurie has an Houriaism Fee, However she is also led by the Holy Spririt for charging. What is your budget?
*
$700-$900
$1000-$1500
$2000
Laurie Requires Hotel and Travel Expenses to be included in the budget for service. Is this something within your budget
*
Yes
No
Number of Speaking Sessions Requested
*
Please List The Day(s) and Time(s) You Would Like to Speak
Will There be a Resource Table Available For Laurie to sell her products?
*
Yes
No
Additional Relevant Information or Requests
Submit
Should be Empty: