Speaking Inquiries

Organization/Church Name(required)

Name(required)

Role/Position(required)

Email Address(required)

Phone Number(required)

Website/Social Media

Event Name(required)

Event Date(s) (YYYY-MM-DD)(required)

Event Location (City, State)(required)

Event Start & End Times(required)

Expected Attendance(required)

Audience Type (check all that apply)

Women's Ministry Church Retreat Homeschool Families Educators Parents Students Community Event Other

Which speaking topic(s) are you interested in?

When God Rewrites the Story Why Whole Books Matter in a Fragmented World Custom Topic (please describe below)

If requesting a custom topic, or if you have a specific event theme, please describe

What type of speaking slot are you looking to fill?

Keynote Session Retreat Conference Workshop Breakout Session Panel Discussion Podcast/Interview Other

How many sessions are requested?

One Two Three More than Three

Preferred speaking length

30 Minutes 45 Minutes 60 Minutes 90 Minutes Half-Day Workshop Full-Day Event

Please tell us about your audience

What are you hoping attendees will walk away with?

Will travel be required? *Anna will be traveling from Lancaster, PA

Yes No

If yes, where will Anna be traveling to?

Will lodging be provided if needed?

Yes No

Will meals be provided?

Yes No

Do you have a budget established for speakers?

Yes No Prefer to Discuss

If yes, please provide a range

Under $500 $500–$1,000 $1,000–$2,000 $2,000+ Other

Anything else you’d like Anna to know about your event, audience, ministry, or vision?