Cart 0

Guest Speaker Information Form

Name *

Name

First Name

Last Name

Email *

Mailing Address *

Mailing Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

Phone

Country

(###)

###

####

Special Guest T-Shirt Size *

TRAVEL COMPANION(S)

If you will be traveling with a companion(s), please provide the following information.

Traveling Companion #1

First Name

Last Name

T-Shirt Size

Traveling Companion #2

First Name

Last Name

T-Shirt Size

Travel Companion #3

First Name

Last Name

T-Shirt Size

Travel Companion #4

First Name

Last Name

T-Shirt Size

Contact/ Assistant Name

First Name

Last Name

Phone

(###)

###

####

TRAVEL AND ACCOMMODATIONS

What mode of transportation will you be arriving in? *

Car

Plane

Charter Plane

Would you like us to book a flight?

Yes

Number of plane tickets needed

ARRIVAL Flight Information

Please provide the following information to allow us to best serve you and provide transportation to and from the airport.

DEPARTURE Flight Information

Is lodging needed?

Yes

If "YES" please provide the following information:

King rooms needed

Double rooms needed

CHECK-IN Date

YYYY

CHECK-OUT Date

YYYY

MEDIA

Media Contact Name

First Name

Last Name

Phone

Country

(###)

###

####

Microphone Preference

Handheld

Lavaliere

BIOGRAPHY: Please email to - liana@braveconference.cc

MEDIA NEEDS such as: Sermons, Scriptures, Notes, Lyrics, etc. please forward to - media@citylifechurch.cc and liana@braveconference.cc

Website

http://

Social media platforms:

PRODUCT

Will you be shipping product ahead?

Yes

Type of products

Number of boxes

Estimated date of delivery

YYYY

Book Signing / Meet & Greet

Yes

Will table assistance be needed?

Yes

Is petty cash needed?

Yes

If using Square account, please provide sign-in and password:

Please provide an accurate inventory and price list of all products:

Can also be inside shipments as well

Make all shipments to:

ATTN: LIANA CRUZ CITYLIFE CHURCH 8411 N. DALE MABRY HWY. TAMPA, FL 33614

GREEN ROOM

Preferred beverages and brand:

Preferred snacks:

Allergies or Special Diet:

FINANCIAL

Make honorarium check payable to:

Make expense check payable to:

PLEASE EMAIL W-9 to liana@braveconference.cc

SPECIAL REQUEST:

If there is anything else you or your team may need during your stay with us please provide the information below.