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Speaking Request Form
Speaking Request Form
Drs. Les and Leslie
2021-08-24T15:29:11-07:00
Your Name
*
First
Last
Your Position/Title
Church or Organization Name
*
Website
Address
*
Street Address
Address Line 2
City
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Armed Forces Americas
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Office Phone
*
Cell Phone
*
Email
*
How did you hear about Drs. Les and Leslie Parrott?
*
What type of event are you interested in scheduling?
*
Fight Night - A 2.5-hour date night experience for couples on any night of the week.
Other
If "Other", Tell us more about the type of event you wish to schedule.
First Choice of Event Date
*
Second Choice of Event Date
*
Third Choice of Event Date
*
Les and Leslie are not always available to speak together at an event. Are you willing to have Les on his own?
Yes
No
Where do you plan to hold the event? (e.g. sanctuary, hotel, conf. center, etc.)
*
How many people does the venue seat?
*
How many people do you expect to attend?
*
If a church, what is your average weekly adult attendance?
What is the nearest major airport?
*
Driving time/mileage from airport to event site?
*
Additional Comments
Comments
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