Seminar Request Form:

Person to Contact:
Seminar Location: This is the actual address where the seminar is to be held.
City:
Nearest Major City:
State/Province:	Zip:
Country:
Seminar Theme:
Main Contact Telephone:	() -
Fax number:	() -
Email Address of Person to contact:
Church or Ministry in charge:
Pastor:
Probable Date (s) of Event: You will be notified if either of the dates are available	to

Please answer the following questions:

1. How many sessions are you thinking of having?
2. Will this include Sunday morning church?	Yes   No
3. Will this be a public event or just your local church?	Community   Church

  4. Is this your first seminar?                Yes   No

5. Do you plan to mail out some brochures?

Yes   No