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Speaking Question Form
Inquiring for Candice Reyes to Speak at your event
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Email
*
Your email
First Name
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Your answer
Last Name
*
Your answer
Email
*
Your answer
Name of Church / Organization
Your answer
City and State of Church/ Organization
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Your answer
Phone Number
Your answer
Name of Event
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Your answer
Event Date
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MM
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DD
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YYYY
Event Location
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Your answer
Number of Attendees Expected
Your answer
Event Description (target audience, event history, your burden, etc.)
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Your answer
Expected Role for Candice (main speaker, workshop speaker, number of session, length of sessions, topic of sessions)
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Your answer
Would Candice have access to audio/ visual support for her session(s)?
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Yes
No
Would you like more information about the Basic Self Defense Workshop?
Yes
No
Maybe
Clear selection
What is the budget you have in mind for this event? (Candice flies from Houston, Texas and usually travels with an assistant)
*
Your answer
Additional Comments
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