Organization
Organization Type
*
Church
College Campus
Student Ministry
Women's Ministry
Recovery Group
Contact Person
*
First Name
Last Name
E-mail
*
Confirmation Email
Phone Number
*
-
Area Code
Phone Number
Event City, State
*
Preferred Event Date
*
-
Month
-
Day
Year
at
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
Preferred Event Date (second choice)
-
Month
-
Day
Year
at
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
Audience type
*
Women (adults)
Women (students)
Women (all ages)
Mixed Gender (adults)
Mixed Gender (students)
Audience Size
*
Under 50
50-250
250-500
500-1000
1000+
Preferred Topic
*
S.C.A.R.S.: Healing the Wounds of Sexual Addiction (Recovery)
Dirty Girls: Not Just a Guy Problem (Awareness/Prevention)
Redefining Identity: Our Past Does Not Define Us
Porn Culture: How Do We Fight It?
Your Kid is Watching Porn: A Warning for Parents
Single On Purpose: Answering God's Call Now
Shades of Grey: The BDSM/Erotica Debate
Love of a Father: Healing Our View of God
Women's Emotional Health (emphasis on Depression/Anxiety)
Greatest Story Ever Told: Effective Church Communications
Dirty Girls Come Clean Campus Tour (High School/College)
"Dirty Girls Come Clean" Book Reading
Recovery Group Facilitator Training
Presentation Type (include number of sessions, length, etc.).
*
Honorarium/Budget
*
Will Crystal be allowed sell her book and other products at the event?
*
Yes
No
Comments (event details, budget concerns, anything else you think Crystal ought to know)
FOR EVENTS OUTSIDE OF KANSAS CITY AREA
Able to Provide Travel & Transportation?
Yes
No
Able to Provide Accommodation?
Yes
No
Submit
Should be Empty: