Company/Association
Please specify organization type CorporationConferenceCollegeChurchOther
Event Title: Website:
First Name: Last Name: Email: Cell Phone:
What is your role with planning the event?
Who in your organization is responsible for signing contracts?
Street Address
City State/Country Billing Postal Code
Event Location City: State/Country: Venue Name:
Will this be indoors of outdoors? IndoorsOutdoors
Date of the event?
How many people will be attending?
Is this a ticketed event? YesNo
Will the event be recorded? YesNo
What date and time would Dr. Renville need to be present?
What exactly would you like Dr. Renville to do? KeynotePanelistConferenceWorkshopCoachConsultMinister
What topics would like Dr. Renville to address?
How long would the presentation last?
Is there more than one appearance requested?
Tell us briefly about the event, its purpose, and demographic of the attendees.
What is your budget?
Is travel/lodging included for the speaker? PLUS one assistant? YesNo
What is the closest airport?
Will ground transportation and meals be provided? **Note: Dr. Renville travels from North Carolina YesNo
Would you like for Dr. Renville to do a book signing at the event? YesNo
Would you like to pre-order books? If so, how many? (approx.)
Is there anything else you'd like for us to know?
