Please use this form to request an appearance by Julie Shematz and/or Beauty From Ashes
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* denotes required field.
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ORGANIZATION
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Organization Name:
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Senior Leadership:
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Website:
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Address:
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Address Line 2:
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City:
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Country:
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State/Province:
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Zip/Postalcode:
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Phone:
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Fax:
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Closest Airport:
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How did you hear about us?
(ex. website, conference, other leader/ministry)
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CONTACT PERSON
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Contact Person Name:
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Title/Position:
(ex: "Personal Assistant")
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Email Address:
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Phone Number:
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Phone Numbe 2:
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REQUESTED DATES
Below you may select up to 3 possible dates.
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Requested Date(1):
Add
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Number of Days Requested
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If a weekend is not available, would you consider mid-week?
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Notes about requested dates:
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EVENT DETAILS
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Event Description:
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Number of Congregations/Organizations Involved:
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Expected Number of Attendees:
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Other Speakers:
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Will someone be able to help run our product table?
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Budget:
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TELL US ABOUT YOUR ORGANIZATION AND/OR EVENT:
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