Embracing God's Design | Speaking Request: Jennifer Bauwens + Walt Heyer Question Title * 1. Please share your name and location: * Your nameOrganization/Ministry Affiliation (if applicable)* City * State Select state AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasU.S. Virgin IslandsUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming* Zip code Question Title * 2. Please add your contact information: *Mobile Phone NumberAlternate Phone Number*Email Address Question Title * 3. Please provide the information for the Event or Organization interested. * Event/Organization Name* Website * City * State Select state AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasU.S. Virgin IslandsUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming* Zip code Question Title * 4. Please share any details that would be helpful for our team to learn more about your request. (Event Details, Anticipated Attendance, Type of Audience, Speaking Time Allotment, etc.) Question Title * 5. Please select which planning phase best applies to your request: Extremely interested, have everything in place to begin promoting! Very interested, planning is underway. Interested, but need more information to create a plan. Somewhat Interested, but simply requesting information. Question Title * 6. Please provide any additional details or notes regarding the host location, including any specific date requests and other pertinent information. Question Title * 7. Which author(s) are you requesting to speak? Requesting Jennifer Bauwens & Walt Heyer to speak. Requesting Jennifer Bauwens only. Requesting Walt Heyer only. Other (please specify) Question Title * 8. Which best describes your event type? Speaker(s) would travel and speak onsite. Speaker(s) would join via online platform during live event. Speaker(s) would make prerecorded remarks. Other (please specify) Question Title * 9. Have you previously hosted any event affiliated with the authors or the organizations they represent? Yes No Question Title * 10. If yes to the above, please share any previous, affiliated event(s) you have hosted. Question Title * 11. Please note any additional information you'd like to share with our team. Finish!