Speaker Request

Organization Name*

Date of Event*

Alternative Event Date*

Address*

Street Address City State / Province / Region ZIP / Postal Code Country

Phone Number*

Church or Pastor Email Address*

Name of Senior Pastor/Leader*

Website

Contact Person responsible for booking this event*

Email address of contact*

Please describe the type of meetings or conference and subject you are interested in scheduling*

Will you cover all expenses related to travel for the event (airfare, lodging, transportation, and meals)?*

The CFL board prefers that our conference staff not travel alone. Would you cover the expense of a second person to travel?*

Will there be other speakers at this event?*

If yes, who

Estimated number of attendance*

Please enter a number from 1 to 10.

Is your church or ministry hosting this event alone or will there be other churches involved?*

Has Christian Family Life previously spoken at an event hosted by your organization?*

If yes, who

Have you or anyone in your ministry led the marriage study, Two Becoming One?*

Would you like to request Sally Meredith to speak?*

Name

This field is for validation purposes and should be left unchanged.