* 1. Your Name

* 2. Your Email

* 3. Event Name

* 4. Date(s) of Event (e.g. 01/20/08 - 01/23/08)

* 5. Type of Event

* 6. Is Ralph the main speaker?

* 7. Other speakers (Speaker1, Speaker2, etc.)

* 8. How many plenary sessions are you requesting Ralph to speak for?

* 9. How many workshops or breakout sessions are you requesting him to speak for?

* 10. Schedule and Duration of speaking times (Plenary Session at 9am on 1/2/08, 1 hour in length)

* 11. Are there particular topics you would like Ralph to speak about?

* 12. Estimated number of attendees

* 13. . Makeup of the attendees (Age range, urban, pastors, lay leaders, church planters, ethnic diversity, etc.)

* 14. Your organization name and mailing address

* 15. Contact person, phone/fax/email info

* 16. How do you know Ralph? (Who referred him to you? Where and when did you meet him?)

* 17. Overall purpose of the event

* 18. Location and address of event

* 19. Location of nearest airport to event

* 20. Is a photograph and biography of Ralph required?

* 21. What typical honorarium do you provide for this event?

* 22. Are you able to provide private hotel accommodations, including the night before and after your event?

* 23. Would you be willing to purchase one of Ralph's books for each attendee and include it in the registration cost of the event?

Other Notes: