|
|
Please fill out this questionnaire and return it to the Speakers Services office with your materials or as soon as possible. This will help us serve you and the meeting planner more accurately. Thank you! 1) Name:___________________________________________________ Social Security # ________________ Address:____________________________________ City:_____________________ State:____ ZIP:_______ Daytime Phone:(_____)_________________________ Evening Phone:(_____)________________________ E-mail Address:________________________________________ Fax:(_____)__________________________ 2) Please fill in the following spaces with your fee structure (set fee per event or range of acceptable fees per event). This amount must include the 20% (or $100, whichever is greater) CLASS fee and should be the same fees you or any other source you may be working with quote. These will be the prices we will quote. Fees are quote "plus expenses" when appropriate. Single
Presentation _________ Single
Presentation _________ 2-4
Presentations, one day
_________ 2-4
Presentations, one day
_________ 2-4
Presentations, two days
_________ 2-4
Presentations, two days
_________ 2-6
Presentations, full weekend _________
2-6
Presentations, full weekend
_________ 3) Are you willing to be flexible on your fees? (Please explain range or circumstances) _______________________________________________________________________________________________ 4) Is there a particular kind of speaking or subject area that you are anxious to do and would be willing to do at almost any fee? If so, what is it? _______________________________________________________________________________________________ _______________________________________________________________________________________________ What is the lowest fee you are willing to do this for? ____________________________ 5) What airport is your home base? ________________________________________ Is there another one within a reasonable range you would be willing to fly from if needed? ______________________________________________________________________________________________ 6) Would you consider yourself: Charismatic Evangelical Fundamental (Please circle one) 7) What is the name and denomination of the church you attend? _______________________________________________________________________________________________ _______________________________________________________________________________________________ 8) Please explain in a few sentences how you became a Christian: _______________________________________________________________________________________________ _______________________________________________________________________________________________ 9) CLASSeminar attended: Location________________________________________ Date ______________________ Small Group Leader___________________________ |
|
|
|
|
|
|
|
