How did you hear about MotivationN3D?
Has Jackie Brewton spoken for your organization before? Yes No
If yes, please give all prior events and dates:
Contact and Organization Information:
Organization Name:
Contact Name:
Contact E-Mail:
Telephone Number:
Street Address:
City: State: Zip Code:
About the Event:
Scheduled date(s) and time(s) of the event:
Briefly describe the following:
What type of event is this? Select One School Assemblies Church Event Youth Conference Parent/Teacher Training Women's Event Retreat Other
If other, please explain:
What is the goal/purpose of the event?
Do you have a theme for this event? If yes, what is it?
If the event is youth or college, will it be co-ed or all females?
Who is the targeted audience? What will be the makeup of the crowd? Age range, urban, suburban, etc.?
How many are you expecting to attend?
Have you had this event in the past? If yes, how many were in attendance?
Where is the event being held?
What are your promotional plans for the event?
Nearest major airport:
Event distance from airport:
Additional information:
Any other comments would help us evaluate the request. Give us as much information as possible to help us understand your event. What do you want to accomplish? What is your vision?
