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Conference Request Form

 
Conference Request Form

Thank you for your interest in scheduling a conference with Elyse. Please complete the following form and send it, along with your organization's Statement of Faith to conferences@elysefitzpatrick.com. Your request will be considered and responded to in a timely manner. Please note that all of Elyse's conferences are not necessarily listed on the Speaking Schedule.
Applicant Information
Your Name:
Organization Name:
Address Street 1:
Address Street 2:
City:
Zip Code: (5 digits)
State:
Organization Affiliation
Affiliation:
Number of members in your congregation:
Contact Information
Daytime Phone:
Evening Phone:
Email:
Conference History
Is this an annual conference?   YesNo
Number of people in attendance last year:  
 
Have you read over the "Scheduling a Conference" information on this site, including the new req's for conferences after 2013?
Do you agree to all the stipulations for scheduling a conference with Elyse (ie. transportation, housing, food, traveling companion)?:
Do you agree that Elyse will fly in on Friday and fly out on Saturday? If not, please explain in a separate email.
Will you allow Elyse to ship in her own books for sale?
Will you furnish at least 2 people to work at the book table during all break times? 
Will you furnish all the attenders with printed notes and pens or pencils?
Do you have PowerPoint capability?
Will you furnish Elyse with either a lapel mic, over-the-ear mic?
Has your organization ever cancelled a conference for non-attendence before? Have you ever cancelled a conference with Elyse before?:
Are you going to advertise this conference to other churches and in your local newspaper?
Do you agree to Elyse's request for honorarium? If not, please explain your position in a separate email. 
Will you have a time of singing?
Do you understand that Elyse needs a full hour for each session's presentation?
Are you planning to have Elyse sign books?
What is the airport Elyse would fly in to/out of? What is the distance from nearest local airport:
What one topic would you like Elyse to present on?
Is the leadership of your church aware of and in agreement with Elyse's message?:
Are the women in your group aware of Elyse's materials?:
How did you become acquainted with Elyse or her materials?:
Other information you want us to consider as we make our decision:
Please send a Statement of Faith to conferences@elysefitzpatrick.com

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