BOOK A LECTURE :: Hope's Voice

PART I: SPEAKER SELECTION

Name:
School / Company Name:
Phone:
Email:

Please select the association(s) you are a member of (if applicable):

Association for the Promotion of Campus Activities (APCA)

National Association for Campus Activities (NACA)

National Orientation Directors Association (NODA)

Please select the lecture you are booking:
Please select your budget range:

Please list your top 5 speaker(s) / trainer(s). We will send out availability requests for the event date to the speaker(s) / trainer(s) you have selected. You will receive a price quote and the list of the available speaker(s) / trainer(s) for your event within one week after the complete form is received.

Number of speaker(s) / trainer(s):

PART II: TRAVEL

Thank you for choosing Hope’s Voice. Please complete the following form so we can book travel arrangements for your speaker(s) / trainer(s). If you are a school please fax or e-mail us a campus map.

Date of Event:

Time of Event:

:

Requested Speaker(s) / Trainer(s) Arrival Time:

:

Nearest Major Airport:
Distance from Airport (best estimate):	miles
Nearest Major Hotel:
Recommended Taxi/Car or Shuttle Service:

Will a representative from your organization be meeting the speaker(s) / trainer(s) at the airport?

Yes

No

If yes, please provide the contact information of the representative meeting the speaker(s) / trainer(s) at the airport.

Name:
Phone:
Email:

Address of the event (include any building names or room numbers):

Address:
Address 2:
City:
State:
Zip:

Notes:

PART III: PROMOTIONAL KIT

KIT 1
1 – Road to Hope Tour DVD ($12.00 retail value)
5 – Does HIV Look Like Me? T-Shirt ($8.00 retail value)
10 – Does HIV Look Like Me? Poster ($30.00 retail value)
Cost: Complimentary

KIT 2 – 15% DISCOUNT
1 – Road to Hope Tour DVD
10 – Does HIV Look Like Me? T-Shirt
30 – Does HIV Look Like Me? Poster
Cost: $150.00

KIT 1
5 – Faces of War T-Shirt ($8.00 retail value)
10 – Faces of War Poster ($30.00 retail value)
Cost: Complimentary

KIT 2 – 15% DISCOUNT
1 – When I Came Home Documentary (Herold) *
1 – American Widow Project Documentary (Taryn) *
10 – Faces of War T-Shirt
30 – Faces of War Poster
Cost: $150.00

* You will receive the documentary of the speaker(s) you book.

Please let us know how many shirts of each size you want.

Small:
Medium:
Large:
X-Large:

Where do you want your selected promotional kit sent

Company:
Department:
Name:
Street Address:
Additional Address Information:
City:
State:
Zip:

To order individual items please contact Hope’s Voice for an order form and custom quote; keep in mind promotion kit packages offer a discount.

Chelsea Gulden	Lolisa Gibson
Christina Rock	Tim Avant
Kevin Fletcher	Todd Murray
Lance Smith

BOOK A LECTURE

CONTRACT INFORMATION FORM

PART I: SPEAKER SELECTION

PART II: TRAVEL

PART III: PROMOTIONAL KIT

OUR MISSION

NEWS AND UPDATES

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