SPEAKING ENGAGEMENT REQUEST FORM

for DR. LOUIS P. BAUER & CASEY SCHALLENBERG, INSPIRATIONAL SPEAKERS

 

            MAIL TO: 103 San Francisco Court, Pearl River, LA  70452

or Call (985) 863-7706 or (985) 863-2272

 Fax:  (985) 863-7706

E-mail: healing@goodtapes.com or jst4casey@aol.com

The form can be printed and mailed to the address indicated on the form

or you can copy and paste the form and email it to the email address listed on the form.

 

PERSON REQUESTING SPEAKER:

CHURCH or ORGANIZATION THE REQUEST IS FOR:

PASTOR’S NAME (if applicable):

CONTACT PERSON:

BUSINESS PHONE #:

HOME PHONE #:

CELL PHONE #:  

FAX #:

ADDRESS OF CONTACT PERSON:

 

 

 

 

DATE/S REQUESTING:

DESCRIPTION / PURPOSE OF ENGAGEMENT / EVENT:

 

 

 

 

LOCATION OF THE ENGAGEMENT / EVENT:

 

 

 

 

PHONE # OF LOCATION:        

STARTING TIME OF ENGAGEMENT / EVENT:

TIME SPEAKERS WILL START SPEAKING:    

LENGTH OF TIME ALLOTED FOR SPEAKERS:

NUMBER EXPECTED IN ATTENDANCE:

TOPIC PREFERENCE:

IS A GROUP BIBLE MEDITATION                       Please circle one:          (   YES   )            (   NO   )               

REQUESTED ALSO?                                            If yes, an additional 20 minutes is needed

SPECIAL INSTRUCTIONS (if any):