Speaker Event Form

Booking Agreement

Complete form below to retain the services of a DINAO speaker
For Direct Inquiries contact John or Renee' Strothers at Dinaowjr@gmail.com or call (757) 904-3464.
Company Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Company Email
example@example.com
Phone Number

Area CodePhone Number
Company Website:
I want this speaker(s)
Name of Event
Nature of Booking
Event Type
Estimated Number of Guest
Select range
Event Start Date & Time

MonthDayYear
DateHourMinutesAM/PM Option
Event End Date & Time

MonthDayYear
DateHourMinutesAM/PM Option
Name of Venue
Venue Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Primary Point of Contact

First NameLast Name
Phone

Area CodePhone Number
E-mail
Honorarium Pricing

Prices based on event type and do not include travel cost. Your payment will not be processed until both parties agree on date and times.
Please select an option
prevnext( X )
Guest Speaker - solo$500.00

Hours

Joint Guest Speaker$850.00

Hours

Weekend Marriage Retreat$3,000.00

Marriage CoachingFree

Please Select Item

Total $0.00
Other - Negotiable
A $500.00 Non-refundable Deposit is required to guarantee Speaking date.
Travel Arrangements

(Includes- Hotel, Meals, Air Fare, Rental Car, General Transportation)
Please select an option
Payment Terms

Please check to show your understanding and agreement with the terms below
Confirm agreement by selecting both
Terms of Agreement
Check to agree with terms
Signature
Should be Empty:

Booking Agreement

Honorarium Pricing

Please select an option

Travel Arrangements

Payment Terms

Terms of Agreement