Survey

Thank you for requesting a part of our team to speak in your community. Please take a few moments to complete all of the information requests that follow.

*
1. Contact/Organization Information

Contact/Organization Information Contact Name:
Organization Name:
Contact Email:
Street Address:
City:
State:
Zip Code:
Contact Cell:
Contact Office or Key Phone:
Website:

*
2. My Role (Check all that apply)

My Role (Check all that apply) School Administrator

Volunteer/Committee Member

Paid Ministry Leader/Staff Member

Event Planner/Coordinator

*
3. Who would you like to have speak?

Who would you like to have speak? Sissy Goff

David Thomas

Stephen James

Sissy Goff and David Thomas

Sissy Goff and Melissa Trevathan

Sissy Goff, Melissa Trevathan and David Thomas

Stephen James and David Thomas

Unsure

*
4. Deciding Factors/Reasons to Invite Speaker(s)

Deciding Factors/Reasons to Invite Speaker(s)

*
5. Event Location Information

Event Location Information Event Location (Theater, Church, Retreat Center):
Location Street Address:
Location City:
Location State:
Location Zip Code:
Location Country:
Website:
Location Phone Number:

*
6. Topic Interest (Check all that apply)

Topic Interest (Check all that apply) Nurturing Boys/Wild Things (David Thomas) (2 or 4 hours)

Raising Girls (Sissy Goff) (2 or 4 Hours)

Modern Parents, Vintage Values (Melissa Trevathan, Sissy Goff, David Thomas) (2 or 4 Hours)

Raising Kids of Character (David Thomas, Melissa Trevathan, Sissy Goff) (2 or 4 Hours)

The Back Door to Your Teen's Heart (David Thomas, Melissa Trevathan, Sissy Goff) (2 Hours)

Boys and Girls: The Differences (David Thomas, Sissy Goff) (4 or 6 hours)

BALL STEAK MAN (David Thomas, Stephen James) (2 hours)

He Said, She Said (David Thomas, Stephen James) (2 hours)

Is He as Clueless as He Acts? (David Thomas, Stephen James) (2 Hours)

Growing Up Without Getting Lost (Sissy Goff, Melissa Trevathan) (for Teen Girls) (2 Hours)

Mirrors and Maps (for Middle School Girls) (Sissy Goff, Melissa Trevathan) (2 Hours)

Discovering God's Themes for Your Marriage (Stephen James)(Retreat)

Discovering God's Themes for Your Life (Stephen James)(Retreat)

Sexual Integrity for Men (Stephen James) (2 or 4 hours)

The Voice of the Heart (Stephen James) (4 or 6 hours)

Other (please specify)

*
7. Desired Event Type

Desired Event Type Retreat

Conference

Teaching Seminar

Banquet

Inservice

*
8. Number of Teaching Sessions Desired

Number of Teaching Sessions Desired 1

2

3

4

*
9. Expected Attendance

Expected Attendance 50 or less

51-100

101-200

201-300

Other (please specify)

*
10. Please List Your First Three Choices of Dates For This Event

	MM		DD		YYYY
1st	Please List Your First Three Choices of Dates For This Event 1st Month	/	Day	/	Year
2nd	2nd Month	/	Day	/	Year
3rd	3rd Month	/	Day	/	Year

*
11. Event Day(s) Preference (check all that apply)

Event Day(s) Preference (check all that apply) Midweek

Friday only

Friday/Saturday

Saturday only

Saturday/Sunday

Sunday only

Other (please specify)

*
12. Registration, Promotion and History Questions (Check all that apply)

Registration, Promotion and History Questions (Check all that apply) This is our first event with a guest speaker

We have had a few events with guest speakers or musicians

We have many events with guest speakers each year and are a "conferencing" organization

This event is to benefit a non-profit

We normally charge registration fees or sell tickets for events

Our events are often free

Our events are primarily for our organization

Our events are for community outreach

We advertise events "inside" our organization

We utilize traditional event marketing methods such as posters, fliers and postcards

We utilize radio and television to promote our events

We employ the use of the internet and social media promotional tools such as FACEBOOK for our events

We will need your advice and assistance in promoting this event outside of our organization

Thank you for completing this information. Please be sure to click DONE below and if desired save a copy of your information by printing.

Thank you for requesting a part of our team to speak in your community. Please take a few moments to complete all of the information requests that follow.

*1. Contact/Organization Information

*2. My Role (Check all that apply)

*3. Who would you like to have speak?

*4. Deciding Factors/Reasons to Invite Speaker(s)

*5. Event Location Information

*6. Topic Interest (Check all that apply)

*7. Desired Event Type

*8. Number of Teaching Sessions Desired

*9. Expected Attendance

*10. Please List Your First Three Choices of Dates For This Event

*11. Event Day(s) Preference (check all that apply)

*12. Registration, Promotion and History Questions (Check all that apply)

*
1. Contact/Organization Information

*
2. My Role (Check all that apply)

*
3. Who would you like to have speak?

*
4. Deciding Factors/Reasons to Invite Speaker(s)

*
5. Event Location Information

*
6. Topic Interest (Check all that apply)

*
7. Desired Event Type

*
8. Number of Teaching Sessions Desired

*
9. Expected Attendance

*
10. Please List Your First Three Choices of Dates For This Event

*
11. Event Day(s) Preference (check all that apply)

*
12. Registration, Promotion and History Questions (Check all that apply)